COMPANY_INFORMATION.pdf

RFQ

BALLISTIC PODIUMS

COMPANY INFORMATION PAGE

1.0 COMPANY IDENTIFICATION

Company Name (include ‘Doing Business As’ (DBA) and/or any suffix of entity type ie. LLC, Inc.):

Company DUNS # and CAGE Code:

Company Federal ID Tax Number:

GSA Contract Number:

Company Address:

Company Point of Contact:

Company email and phone number: 2.0 ADDITIONAL INFORMATION

Business Size (mark all that apply):

___Small Business ___Other Than Small Business ___HUBZone

___Service-Disabled Veteran-Owned Small Business ___8(a) Certified Small Business

___Women-Owned Small Business (WOSB) ___Economically Disadvantaged WOSB

___Other:

3.0 LIST OF PRESENT/PAST PERFORMANCE REFERENCES

Reference 1 Company Name:

Reference 1 POC Name:

Reference 2 Company Name:

Reference 2 POC Name

Reference 3 Company Name

Reference 3 POC Name

4.0 REPRESENTATION AND CERTIFICATION

I, ______________________________________________________, represent that, to the best of my knowledge and belief, the information included in my quote is complete, accurate, and true.

Signature and Date Printed Name and title