Attachment A - Additional Information Sheet.docx

SOLICITATION #28321321Q00000011 ATTACHMENT A

ADDITIONAL INFORMATION SHEET

In addition to the quotation, please provide the following information:

1. General Information

Date of Quote: Click or tap to enter a date.

Company Name: Click or tap here to enter text.

Contact Name: Click or tap here to enter text.

Phone Number: Click or tap here to enter text.

Contact Email: Click or tap here to enter text.

TIN/EIN Number: Click or tap here to enter text.

DUNS Number: Click or tap here to enter text.

Does your company have active registration in the System for Award Management (SAM)?

Yes ☐ No ☐ The vendor must have active registration in SAM to be eligible for an award.

** The vendor may create a new registration or update its representations through the following link – https://www.sam.gov/SAM/**

1. 1 Business Status (check those that apply):

☐ Small ☐ Large ☐ Disadvantaged ☐ 8(a) ☐ Women-Owned Small Business ☐ Service Disabled Veteran Owned Small Business

1. 2 Delivery Terms:

Delivery date: Click or tap to enter a date.

FOB: Click or tap here to enter text.

(Unless otherwise specified, all shipments will be FOB Destination.)

Contract Type and Price Verification:

☐ GSA/SEWP contract number (if applicable): Click or tap here to enter text., or ☐ Open market.

For GSA quotes, provide snapshots of the applicable items from the vendor’s GSA contract price list. For open market quotes, provide snapshots of the applicable items from the vendor’s published price list.

1. 3 GSA Teaming or Partnership Arrangement:

If subcontracting, partnership, reseller, or teaming arrangements are utilized, provide documentation of business agreements. If the Offeror is not the contract holder of the GSA FSS contract upon which the quotation is based, include documentation of ‘Contractor Teaming Agreement’ or other GSA-authorized contractual relationship with the GSA FSS contract holder.

1. 4 Authorized Reseller Status:

Is your company the manufacturer of the quoted sofrtware product(s)?

Yes ☐ No ☐ If your company is not the software manufacturer, provide documentation of status as an authorized reseller of the quoted software.

2. Supply Information (IF APPLICABLE)

Identify the principal plant or place of business where the items will be produced, supplied from stock, or where the service will be performed:

Click or tap here to enter text.

(Street Address) Click or tap here to enter text.

(City, State, Zip)

Indicate whether the place of manufacture of the end product(s) is within or outside the United States: Click or tap here to enter text.

3. Warranty Information (IF APPLICABLE)

Warranty period of coverage: Click or tap to enter a date. – Click or tap to enter a date.

Repairs: ☐ On-site ☐ Off-site Warranty includes: ☐ Parts ☐ Labor Warranty information phone number and contact person:

Click or tap here to enter text.

(Name) Click or tap here to enter text.

(Email & Phone Number)

4. Maintenance Information (If APPLICABLE)

Period of coverage: Click or tap to enter a date. – Click or tap to enter a date.

Phone number for Technical Support and contact person:

Click or tap here to enter text.

(Technical support Name) Click or tap here to enter text.

(Technical support Email & Phone Number(s)) Click or tap here to enter text.

(Technical support email address)

Days and hours of coverage, e.g., 24/7/365 (24 hours a day, 7 days a week, 365 days a year for technical assistance):

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Includes (check all that apply):

☐ updates ☐ upgrades ☐ fixes

Site visits (indicate how many will be necessary and any travel costs that apply):

Click or tap here to enter text.

Other (provide specific information, including any additional costs):

Click or tap here to enter text.

Specify maintenance terms:

☐ begins after expiration of warranty ☐ begins upon delivery/acceptance of product

Please provide the following information:

Place of Performance: Provide the physical location where the item is manufactured or supplied from stock. If software maintenance and support, insert the physical address of the technical support personnel who answer the Technical Support phone number listed above. This information must include the city, county, state, country and Zip+4 code.

Click or tap here to enter text.

(Street) Click or tap here to enter text.

(State & Zip Code)

Country of Origin: Please indicate if the product is a domestic end product. If product is foreign, please indicate the country of origin. A domestic end product is where an item is an unmanufactured end product that has been mined or produced in the United States or an end product manufactured in the United States if the components that are mined, produced, or manufactured in the United States exceeds 50 percent of the entire cost of all components.

Click or tap here to enter text.

If the solicitation so authorizes, the vendor may offer items equivalent to those described therein; however, the vendor must submit specifications that demonstrate their equivalence.

Conformance with Applicable Section 508 standards:

The Offeror hereby ensures that maintenance upgrades pursuant to this order shall not do not reduce the software’s level of conformance with Section 508 standards applicable at the time the order is awarded:

☐ Yes ☐ No