Attachment 2 - Product Sourcing Request.docx
DOCX document 196 KB Posted
- Attached to
- 6515--Textiles - Towels and Washcloths
- Solicitation number
- 36C24E26Q0108
About this file
This is a Vendor Verification and Product Sourcing Request form template used by the Department of Veterans Affairs Medical Surgical Prime Vendor (MSPV) Program to collect supplier and manufacturer information for products under consideration for the program. The form serves to verify supplier and manufacturer identity, business designation, and socio-economic status to support fair and competitive contracting review and solicitation processes.
The form requires new suppliers and manufacturers to provide comprehensive business information including company name, email address, Unique Entity Identifier (UEI), and DUNS number. If the manufacturer differs from the supplier, manufacturers must submit their own detailed information via the form, including name, email, UEI, and DUNS. Completion of this form is mandatory for new suppliers and manufacturers submitting products for MSPV consideration; however, submission does not guarantee contract award. Completed forms must be submitted via email to vha19plologmspocom@va.gov. This template is a standardized document designed to streamline the vendor verification process for the VA's Medical Surgical Prime Vendor Program and does not address specific products, services, pricing, or award dates.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24E26Q0108 0001.docx | DOCX document | |
| 36C24E26Q0108.docx | DOCX document | |
| Attachment 3 - MSPV Bulk PSR Template.zip | ZIP file | |
| Attachment 1 - MTR for Reusable Textile.xlsx | XLSX spreadsheet |
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Text version
Vendor Verification & Product Sourcing Request (PSR) Purpose The Vendor Verification Form collects and verifies supplier and manufacturer identity, business designation, and socio-economic status for items submitted for consideration in the MSPV program, supporting a fair and competitive contracting review and solicitation process.
Note: Completion of this form does not guarantee a contract award.
Requirements and Instructions for Submitting the Verification Form:
New suppliers and manufacturers seeking to have products considered for the MSPV program must complete vendor verification and submit it with the product submission. The information is used to validate the identity of potential new suppliers.
Instructions
· New suppliers/manufacturers must complete this form and submit it with product submission for MSPV consideration.
· This form is for supplier information. If the manufacturer is different, submit manufacturer details via PSR (link).
Supplier Information (Required) Supplier Name: _______________________________________________ Supplier Email: _________________________________________________ Supplier UEI: _________________________________________________ Supplier DUNS: _______________________________________________ Manufacturer Information ☐ Manufacturer is the same as Supplier (no additional submission needed) ☐ Manufacturer is different from Supplier (complete manufacturer information below) Manufacturer Name: ______ _______________________________ Manufacturer Email: _____________________________________ Manufacturer UEI: __ ________________________________________ Manufacturer DUNS: ___________________________________________ Submission: Email completed Vendor Verification Form to: vha19plologmspocom@va.gov image1.png
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