Contractor-Information-Form_N4008422Q0008.pdf

(Rev. 03/13)

CONTRACTOR INFORMATION FORM

N4008422Q0008

THREE (3) EACH 2-TON REFRIGERATED TRUCKS

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

1. Contractor Information:

Firm Name:

Unique Entity ID

(UEI) fr. SAM.gov: CAGE Code:

Address:

Point of contact for firm:

Phone Number of POC: Email of POC:

2. Make and Model of Proposed REFRIGERATED TRUCKS:

Place of manufacture:

For the proposed model, choose all that apply: I am the manufacturer I am an Authorized Distributor/Reseller

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

General Requirements for NEW Refrigerated Truck Comments if any (optional) Refrigerated Truck complies with Japanese Motor Vehicle Safety Standards, including but not limited to, exhaust emission control requirements

Yes No

4X2 Yes No

Minimum 2,000kg loading capacity Yes No

If NO, enter available Loading Capacity:

____________kg

Refrigerated cargo van body, able to hold temperature of cargo area between -20C° to 5C°

Yes No

Right hand drive Yes No

Power Steering Yes No

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

Air Conditioner Yes No

Diesel Engine Yes No

Automatic Transmission Yes No

VEHICLE DIMENSIONS:

Cargo Room Inside Length:

Cargo Room Inside Width:

Cargo Room Inside Height:

Millimeter or Inches

____________mm

____________mm

____________mm

Rushing Rails and Belts shall be installed 2 pairs on both sides of van body inside and 1 set rushing belt

Yes No

Back camera and monitor Yes No

Antilock Brake Systems (ABS) Yes No

Manufacturer's standard and double rear wheels/tires. Yes No

Central locking control with keyless remote entry. Yes No

Delivery Period _____________ days

Misc. requirements Capability providing manufacture standard warranty service/work (must be provided within 50 kilometers of the following delivery points):

a. Yokosuka, Japan

b. Sagamihara, Japan

c. Sasebo, Japan

Yes No

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

Yes No