Contractor_Information_Form.docx
DOCX document 22 KB Posted
- Attached to
- Design-Bid-Build, for the P4040 French Creek Ambulatory Care Clinic, Camp Lejeune, North Carolina.
- Solicitation number
- N4008521R2524
About this file
This document contains a sources sought notice and related contractor information form for a design-bid-build project. The Naval Facilities Engineering Command, Mid-Atlantic is seeking small businesses capable of performing design and construction services for a $10-25 million project to construct a 16,378 square foot single-story ambulatory care clinic addition and alter an existing 11,917 square foot clinic at Camp Lejeune, North Carolina. Interested contractors should submit a capabilities package by 2:00 PM Eastern Time on December 3, 2020 including a contractor information form, as well as information on two to five relevant past projects demonstrating experience with similar size, scope and complexity of construction and renovation. The appropriate NAICS code is 236220 and the contract is expected to be awarded in January 2021.
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Other files
| File | Type | Posted |
|---|---|---|
| Project_Information_Form.docx | DOCX document | |
| Project Matrix P4040.xlsx | XLSX spreadsheet |
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Text version
SOURCES SOUGHT – CONTRACTOR INFORMATION FORM
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.
| 1. Contractor Information: |
| DUNS: |
| CAGE Code: |
| Firm Name: |
| Address: |
| Name of POC for firm: |
| Phone Number of POC: |
| Email of POC: |
2. Type of Business: (check all that apply)
| |_| SBA certified 8(a) firm |
| |_| SBA certified HUBZone Small Business |
|_| Service-Disabled Veteran-Owned Small Business
|_| Veteran Owned Small Business
|_| Woman Owned Small Business
|_| Economically Disadvantaged Women-Owned |_| Small Business Small Business
3. Bonding Capacity:
| Surety Name: |
| Maximum bonding capacity per project: |
| $ |
| Aggregate maximum bonding capacity: |
| $ |
4. This space may be used to provide any additional information to clarify the above items only:
Please DO NOT change content of the form
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