Attachment 4_Offeror Information Form.pdf

ATTACHMENT 4 – Offeror Information Form

80KSC026R0007 – Launch Complex (LC) 39 Area Duct Bank System Replacement

1. Offeror Information

a. Offeror Name:

b. Name of person authorized to contractually bind the company:

i. Phone Number:

ii. Email Address:

c. Name of point of contact (POC):

i. Phone Number:

ii. Email Address:

d. Design-Build Prime Contractor Name:

i. Address:

ii. Unique Entity Identifier (UEI) number:

iii. Commercial and Government Entity (CAGE) code:

iv. Business Size:

e. Design-Build Subcontractors Names as Identified in Phase 1 Proposal:

i. Addresses:

ii. Unique Entity Identifier (UEI) numbers:

iii. Commercial and Government Entity (CAGE) codes:

iv. Business Sizes: (State: Small Business (SB), Small Disadvantaged Business (SDB), Service-Disabled Veteran Owned SB (SDVOSB), Women-Owned Small Business (WOSB), and/or Historically Underutilized Business Zone (HUBZone), Large business

(LB).

2. Legal Structure

a. Type of Legal Structure:

i. Integrated Design-Builder

ii. Joint Venture

iii. Prime-Sub Contractors

iv. Limited Liability Company (LLC)

v. Other (explain)

b. Use the below space to describe your firm's legal structure: integrated Design-Builder, joint venture, limited liability company (LLC), prime-sub contractors, or other.

3. Responsible Determination in accordance with FAR 9.104-1 General Standards Please provide information as an attachment to this form specifically addressing each element under FAR 9.104- 1 to demonstrate responsibility:

a. Have adequate financial resources to perform the contract, or the ability to obtain them.

b. Be able to comply with the required or proposed delivery or performance schedule, taking into consideration all existing commercial and governmental business commitments.

c. Have a satisfactory performance record (see 9.104-3 (b) and subpart 42.15). A prospective contractor shall not be determined responsible or non-responsible solely on the basis of a lack of relevant performance history, except as provided in 9.104-2.

d. Have a satisfactory record of integrity and business ethics (for example, see subpart 42.15).

e. Have the necessary organization, experience, accounting and operational controls, and technical skills, or the ability to obtain them (including, as appropriate, such elements as production control procedures, property control systems, quality assurance measures, and safety programs applicable to materials to be produced or services to be performed by the prospective contractor and subcontractors).(See 9.104-3(a).)

f. Have the necessary production, construction, and technical equipment and facilities, or the ability to obtain them (see 9.104-3(a)).

g. Be otherwise qualified and eligible to receive an award under applicable laws and regulations (see also inverted domestic corporation prohibition at 9.108).