Attachment S-4 BusinessDeclarationForm.pdf

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Attached to
Program Management and Executive Administrative Support
Solicitation number
693KA9-20-R-00013
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This solicitation requests offers for program management and executive administrative support services. Vendors must provide administrative, technical, and management support to accomplish tasks consistent with the Federal Aviation Administration's acquisition management systems and strategic plan. The period of performance is two years consisting of a 12-month base period and one 12-month option period. The North American Industry Classification code is 541611 and the small business size standard is $16.5 million. The solicitation will be awarded using a tiered order of precedence giving priority to service-disabled veteran-owned small businesses, then eligible 8(a) certified businesses, then small businesses, and lastly full and open competition. Responses are due no later than 4PM ET on October 8, 2020 and must be submitted electronically to the contracting officer. The FAA will conduct a question and answer period and reserves the right to make multiple awards if in its best interest.

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Other files

File Type Posted
QA Responses_Final.doc DOC document
Attachment J-1 Min Quals for Admin Personnel_Rev 1.doc DOC document
693KA9-20-R-00013 Section B Amendment 4.docx DOCX document
693KA9-20-R-00013 SF-33.pdf PDF
693KA9-20-R-00013 draft rev 082720.docx DOCX document
Attachment J-1 Min Quals for Admin Personnel.doc DOC document
Attachment S-2 CLIENT AUTHORIZATION LETTER Warrenton.docx DOCX document
Attachment S-3 Past Performance Questionnaire 042820.doc DOC document
Attachment S-1_Question and Comments Form_.doc DOC document

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OMB Control No. 2120-0595 FAA Template No. 61 (rev. 10/08)

BUSINESS DECLARATION

1 Name of Firm:

Tax Identification No.:

2 Address of Firm:

DUNS No.:

3 a. Telephone Number of Firm: b. Fax Number of Firm:

4 a. Name of Person Making Declaration

b. Telephone Number of Person Making Declaration

c. Position Held in the Company

5 Controlling Interest in Company (“X” all appropriate boxes)

a. Black American b. Hispanic American c. Native American d. Asian American

e. Other Minority (Specify) f. Other (Specify)

g. Female h. Male i. 8(a) Certified (Certification letter attached) j. Service Disabled Veteran Small Business

6 Is the person identified in Number 4 above, responsible for day-to-day management and policy decision making, including but not limited to financial and management decisions?

a. Yes b. No (If “NO,” provide the name and telephone number of the person who has this authority.)

7 Nature of Business (Specify all services/products (NAIC))

8 (a) Years the firm has been in business (b) No. of Employees

9 Type of Ownership: a. Sole Ownership b. Partnership

c. Other (Explain)

Gross receipts of the firm for the last three years:

a.1. Year

Ending:

b.1. Gross

Receipts a.2. Year Ending:

b.2. Gross Receipts a.3. Year Ending:

b.3. Gross Receipts

Is the firm a small business? a. Yes b. No

Is the firm a service disabled veteran owned small business? a. Yes b. No

Is the firm a socially and economically disadvantaged small business? a. Yes b. No

I DECLARE THAT THE FOREGOING STATEMENTS CONCERNING

ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF. I AM

AWARE THAT I AM SUBJECT TO CRIMINAL PROSECUTION UNDER THE PROVISIONS OF 18 USCS 1001.

14. a.

Signature

b. Date:

c. Typed Name

d. Title:

Attachment S-4 693KA9-20-R-00013

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