Attachment 3 - Offeror Response Form.pdf

PDF 96 KB Posted

Attached to
PKB Gate 4 Camera (Commodity)
Solicitation number
FA461326Q0023
Issued by

About this file

This is an Offeror Response Form for federal contract solicitation FA461326Q0023 issued by the U.S. Air Force for a PKB Gate 4 Camera procurement. The form is a template designed to collect standardized company and quote information from potential offerors responding to this solicitation. Offerors are required to provide company registration details including SAM.gov registration, CAGE number, Unique Entity ID, mailing address, and socioeconomic status classification (Small Business, Service-Disabled Veteran-Owned Small Business, HUBZone, 8(a), etc.). Additional required information includes a point of contact with email and phone number, FOB point, place of manufacture, quote number, quote validity period, period of performance, quote date, and discount terms.

The form contains three mandatory certifications that offerors must complete. First, offerors must confirm whether their pricing includes all direct and indirect costs to meet solicitation requirements. Second, they must certify current registration status with the System for Award Management (SAM.gov) at the time of quote submission. Third, offerors must disclose whether they received 80 percent or more of annual gross revenues from federal contracts and assistance totaling $25,000,000 or more in the preceding fiscal year, with compliance implications for either response option (RFO 4.208(e) or RFO 52.204-10).

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Text version

Attachment 3 – Offeror Response Form

FA461326Q0023

Solicitation Number: FA461326Q0023 Description: PKB Gate 4 Camera

Company Information

Company Name (as registered in SAM.gov):

Company Doing Business As (if applicable):

Cage Number: Unique Entity ID:

Mailing Address:

Socioeconomic Status (SB, SDB, WOSB, EDWOSB, VOSB, SDVOSB, 8(a), 8(a) JV, HUBZone):

Point of Contact:

Email: Phone number:

FOB Point:

Place of Manufacturer:

Quote Number: Quote Valid Until:

Period of Performance:

Quote Date:

Discount Terms:

Confirm pricing includes all costs, direct and indirect, to complete the requirements in accordance with this solicitation: YES NO

Registered with System for Award Management at the time of submission of quote:

YES NO

In the preceding fiscal year, did your company received 80 percent or more of its annual gross revenues from Federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of Federal financial assistance; and did $25,000,000 or more in annual gross revenues come from Federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of Federal financial assistance:

YES If Yes, compliance IAW RFO 4.208(e) applies.

NO If No, then the requirements of RFO 52.204-10 do not apply

Check Box1: Off
Check Box2: Off
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off

File details come from the government source that posted it. Updated .