ATTACHMENT B SOURCES SOUGHT CONTRACTING INFO FORM_10-10-2024.pdf

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

USCG - RMACC III

Use this form to provide contractor’s general information. Please limit response to one page. The box at the bottom of this form may be used to clarify any requested information. E-mail submission to RMACC mailbox and region/district POC’s.

1. Contractor Information: UEI: CAGE Code:

Firm Name:

Headquarters

Address:

Name of POC for firm:

Phone Number of POC: Email of POC:

Primary NAICS Codes

Primary USCG District Alternate Districts

2. Type of Business: (select all that apply)

SBA certified 8(a) firm Veteran Owned Small Business

Service-Disabled Veteran-Owned Small Business Woman Owned Small Business

Small Business Economically Disadvantaged Women-Owned Small Business

SBA certified HUBZone Small Business

Provide date of anticipated graduation from 8(a) or Small Business program if applicable:

3. Bonding Capacity:

Surety Name:

Maximum bonding capacity per project: $ Aggregate maximum bonding capacity: $

4. This space may be used to provide any additional related information. Provide brief summary of construction experience including design-build in regions/districts you are interested in:

Please DO NOT change content of the form

ATTACHMENT B