ATTACHMENT 11_SFS FORM 12.xlsx
XLSX spreadsheet 22 KB Posted
- Attached to
- Construct Medical Readiness Facility Federal contract opportunity
- Solicitation number
- W50S9F22R0001
- Issued by
- Department of the Army National Guard
About this file
This solicitation requests proposals for the construction of a Medical Readiness Facility at Truax Field in Madison, Wisconsin. The single firm fixed-price contract seeks all labor, materials, equipment, and supervision necessary to construct an 18,650 square foot, two-story facility including administrative space and storage. In addition to the base requirements, there are nine options that can be awarded. The project value is estimated between $5-10 million. Interested parties must register in the System for Award Management and attend the pre-proposal conference on March 31, 2022. Proposals are due by May 5, 2022 and will be evaluated for technical merit, past performance, and price. The contract period is 450 days from notice to proceed. The North American Industry Classification code is 236220 and the size standard is $39.5 million.
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Text version
Sheet1
| TRUAX FIELD PRE-AUTHORIZATION REQUEST FORM | |||||||
| Company Name: | Project Location: | Construct Medical Readiness Facility | |||||
| Company POC: | Project Prime: | ||||||
| Company Address: | Start Date: | ||||||
| End Date: | |||||||
| Company POC PH#: | Project POC: | ||||||
| Company POC Email: | Project POC Phone #: | ||||||
| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| NAME: LAST | FIRST | MI | DOB | M/F | DRIVER'S LICENSE #/STATE | PREVIOUS STATE RESIDED | |
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| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| Validated by: | Authenticated by: | ||||||
| Date: | Date: | ||||||
| 115 SFS Form 12 (30JUL19) |
| Company Name: | Project Location: | ||||||
| Company POC: | Project Prime: | ||||||
| Company Address: | Start Date: | ||||||
| End Date: | |||||||
| Company POC PH#: | Project POC: | ||||||
| Company POC Email: | Project POC Phone #: | ||||||
| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| NAME: LAST | FIRST | MI | DOB | M/F | DRIVER'S LICENSE #/STATE | PREVIOUS STATE RESIDED | |
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| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| Validated by: | Authenticated by: | ||||||
| Date: | Date: | ||||||
| 115 SFS Form 12 (30JUL19) | |||||||
| TRUAX FIELD PRE-AUTHORIZATION REQUEST FORM | |||||||
| Company Name: | Project Location: | ||||||
| Company POC: | Project Prime: | ||||||
| Company Address: | Start Date: | ||||||
| End Date: | |||||||
| Company POC PH#: | Project POC: | ||||||
| Company POC Email: | Project POC Phone #: | ||||||
| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| NAME: LAST | FIRST | MI | DOB | M/F | DRIVER'S LICENSE #/STATE | PREVIOUS STATE RESIDED | |
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| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| Validated by: | Authenticated by: | ||||||
| Date: | Date: | ||||||
| 115 SFS Form 12 (30JUL19) | |||||||
| TRUAX FIELD PRE-AUTHORIZATION REQUEST FORM | |||||||
| Company Name: | Project Location: | ||||||
| Company POC: | Project Prime: | ||||||
| Company Address: | Start Date: | ||||||
| End Date: | |||||||
| Company POC PH#: | Project POC: | ||||||
| Company POC Email: | Project POC Phone #: | ||||||
| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| NAME: LAST | FIRST | MI | DOB | M/F | DRIVER'S LICENSE #/STATE | PREVIOUS STATE RESIDED | |
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| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| Validated by: | Authenticated by: | ||||||
| Date: | Date: | ||||||
| 115 SFS Form 12 (30JUL19) | |||||||
| TRUAX FIELD PRE-AUTHORIZATION REQUEST FORM | |||||||
| Company Name: | Project Location: | ||||||
| Company POC: | Project Prime: | ||||||
| Company Address: | Start Date: | ||||||
| End Date: | |||||||
| Company POC PH#: | Project POC: | ||||||
| Company POC Email: | Project POC Phone #: | ||||||
| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| NAME: LAST | FIRST | MI | DOB | M/F | DRIVER'S LICENSE #/STATE | PREVIOUS STATE RESIDED | |
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| NAME MUST MATCH WHAT IS ON YOUR DRIVER'S LICENSE | |||||||
| Validated by: | Authenticated by: | ||||||
| Date: | Date: | ||||||
| 115 SFS Form 12 (30JUL19) |
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