Business Management Questionnaire.docx
DOCX document 18 KB Posted
- Attached to
- FSA Dialectical Behavior Therapy Protocol Federal contract opportunity
- Solicitation number
- BRQ15BNAS23Q00000022
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| 15BNAS23Q00000022 - FSA Dialectical Behavior Therapy Protocols.pdf |
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Text version
BUSINESS MANAGEMENT QUESTIONNAIRE
(a) Provide the work distribution, by percentage, among commercial contracts and Government contracts (including prime and subcontracts).
Commercial: __________percent Government: __________percent
(b) List the last three contracts awarded to your firm which are of a related nature, indicating for each the following:
(1)(a) Customer & Address: __________________________________________________
(b) Contract Number:_____________________________
| (c) Person to Contact:___________________________ | |
| (Phone)____________________________________________ |
(d) Type of Work: ___________________________________
(e) Amount of Contract:$________________________________
(f) Contract Status: [ ] Active [ ] Complete
(2)(a) Customer & Address: __________________________________________________
(b) Contract Number:_____________________________
| (c) Person to Contact:___________________________ | |
| (Phone)____________________________________________ |
(d) Type of Work: ___________________________________
(e) Amount of Contract:$________________________________
(f) Contract Status: [ ] Active [ ] Complete
(3)(a) Customer & Address: __________________________________________________
(b) Contract Number:_____________________________
| (c) Person to Contact:___________________________ | |
| (Phone)____________________________________________ |
(d) Type of Work: ___________________________________
(e) Amount of Contract:$________________________________
(f) Contract Status: [ ] Active [ ] Complete
(4) Bank Reference:
(a) Name of Bank:____________________________________________
(b) Address: ____________________________________________________________ (Phone)_____________________________________________________
| (c) Person to Contact:______________________________________ |
| (Phone)____________________________________________________ |
(5) Total estimated amount of work under this contract that your firm will complete (excluding subcontractors):
__________ percent
(6) Please provide your Unique Entity Identification (UEI) Number
(7) If applicable, please provide your Parent Company’s Unique Entity Identification (UEI) Number
Business Management Questionnaire - RFQ: 15BNAS23Q00000022 Page 2 of 2
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