Contractor-Information-Form_N4008422Q0006.pdf

(Rev. 03/13)

CONTRACTOR INFORMATION FORM

N4008422Q0006

STREET SWEEPER

Use this form to provide contractor’s general information. Please limit response to one page.

1. Contractor Information:

Firm Name:

DUNS Number: CAGE Code:

Address:

Point of contact for firm:

Phone Number of POC: Email of POC:

2. Make and Model of Proposed Street Sweeper: ____________________________________________________________

Place of manufacture: ________________________________________________________________________________

For the proposed model, choose all that apply: ○ Manufacturer ○ Authorized Distributor/Reseller

3. Technical Capability - Please check “Yes” or “No”, and/or add comments if any.

General Requirements Comments if any (optional) Dual System (Mechanical and Vacuum System) Yes No

Diesel Engine

Yes No

Left-side Steering

Steering System: 4 wheel steering (4WS)

Movable Front Brush

Maximum Capacity of Dust Collection Maximum

____________Liter

Delivery Period _____________ days

Misc. requirements Capability providing operator’s manual, shop repair manual, and parts catalog in Japanese.

**Form may be expanded. Please DO NOT change content of the form.** (Rev. 03/13)

Capability providing Operator training and Maintenance, inspection and testing training in Japanese at Camp Zama, Japan.

Capability providing manufacture standard warranty work (i.e., warranty work to be provided in Zama, Japan).