ATTACHMENT 2 Business Declaration.doc

DOC document 69 KB Posted Jun 26, 2015

Attached to: Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
Solicitation number: DTFAAC-15-R-04332
Issued by: Department of Transportation Federal Aviation Administration Aeronautical Center

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ATTACHMENT 2 Business Declaration (doc)

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File	Type	Posted
Amendment of Solicitation SF 30.pdf	PDF	Jun 30, 2015
Q A SIR DTFAAC-15-R-04332-0001.pdf	PDF	Jun 30, 2015
ATTACHMENT 3b SF1035 20CDRL 1 example.pdf	PDF	Jun 30, 2015
ATTACHMENT 3d Travel Authorization CDRL 2 Form.pdf	PDF	Jun 30, 2015
SIR Cover page.docx	DOCX document	Jun 30, 2015
ATTACHMENT 3c CDRL 2 Travel Authorization Form.pdf	PDF	Jun 30, 2015
Amendment of Solicitation SF 30 version 0002.pdf	PDF	Jun 30, 2015
Amended SIR DTFAAC-15-R-04332-0002.pdf	PDF	Jun 30, 2015
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf	PDF	Jun 30, 2015
Attchment 5 Sample Trips w GH.pdf	PDF	Jun 30, 2015
Amended SIR DTFAAC-15-R-04332-0001.pdf	PDF	Jun 30, 2015
ATTACHMENT 1 SOW.pdf	PDF	Jun 30, 2015
ATTACHMENT 3 CDRL 1 Invoice.pdf	PDF	Jun 30, 2015
ATTACHMENT 4 Updated GH Locations.pdf	PDF	Jun 30, 2015
ATTACHMENT 2 Business Declaration.doc	DOC document	Jun 30, 2015
ATTACHMENT 1 SOW.pdf	PDF	Jun 26, 2015
ATTACHMENT 3d Travel Authorization CDRL 2 Form.pdf	PDF	Jun 26, 2015
Amended SIR DTFAAC-15-R-04332-0001.pdf	PDF	Jun 26, 2015
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf	PDF	Jun 26, 2015
Q A SIR DTFAAC-15-R-04332-0001.pdf	PDF	Jun 26, 2015
Attchment 5 Sample Trips w GH.pdf	PDF	Jun 26, 2015
ATTACHMENT 3c CDRL 2 Travel Authorization Form.pdf	PDF	Jun 26, 2015
ATTACHMENT 4 Updated GH Locations.pdf	PDF	Jun 26, 2015
SIR Cover page.docx	DOCX document	Jun 26, 2015
Amendment of Solicitation SF 30.pdf	PDF	Jun 26, 2015
ATTACHMENT 3 CDRL 1 Invoice.pdf	PDF	Jun 26, 2015
ATTACHMENT 3b SF1035 20CDRL 1 example.pdf	PDF	Jun 26, 2015
ATTACHMENT 1 SOW.pdf	PDF	Jun 3, 2015
ATTACHMENT 3d Travel Authorization CDRL 2 Form.pdf	PDF	Jun 3, 2015
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf	PDF	Jun 3, 2015
ATTACHMENT 3b SF1035 20CDRL 1 example.pdf	PDF	Jun 3, 2015
SIR Cover page.docx	DOCX document	Jun 3, 2015
Attchment 5 Sample Trips w GH.pdf	PDF	Jun 3, 2015
ATTACHMENT 3 CDRL 1 Invoice.pdf	PDF	Jun 3, 2015
ATTACHMENT 4 List of GH locationsV2.pdf	PDF	Jun 3, 2015
ATTACHMENT 2 Business Declaration.doc	DOC document	Jun 3, 2015
SIR DTFAAC-15-04332.docx	DOCX document	Jun 3, 2015
ATTACHMENT 3c CDRL 2 Travel Authorization Form.pdf	PDF	Jun 3, 2015
ATTACHMENT 4 List of GH locationsV2.pdf	PDF	Jun 2, 2015
ATTACHMENT 3c CDRL 2 Travel Authorization Form.pdf	PDF	Jun 2, 2015
ATTACHMENT 3b SF1035 20CDRL 1 example.pdf	PDF	Jun 2, 2015
ATTACHMENT 3 CDRL 1 Invoice.pdf	PDF	Jun 2, 2015
SIR DTFAAC-15-04332.docx	DOCX document	Jun 2, 2015
ATTACHMENT 2 Business Declaration.doc	DOC document	Jun 2, 2015
SIR Cover page.docx	DOCX document	Jun 2, 2015
ATTACHMENT 5 Sample Trips w GH.pdf	PDF	Jun 2, 2015
ATTACHMENT 3d Travel Authorization CDRL 2 Form.pdf	PDF	Jun 2, 2015
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf	PDF	Jun 2, 2015
ATTACHMENT 1 SOW.pdf	PDF	Jun 2, 2015
ATTACHMENT 4 List of GH locationsV2.pdf	PDF	Jun 2, 2015

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BUSINESS DECLARATION

Name of Firm:

Tax Identification No.:

Address of Firm:

DUNS No.:

a. Telephone Number of Firm:

b. Fax Number of Firm:

a. Name of Person Making Declaration

b. Telephone Number of Person Making Declaration

c. Position Held in the Company

Controlling Interest in Company (“X” all appropriate boxes)

FORMCHECKBOX

a. Black American

FORMCHECKBOX

b. Hispanic American

FORMCHECKBOX

c. Native American

FORMCHECKBOX

d. Asian American

FORMCHECKBOX

e. Other Minority (Specify)

FORMCHECKBOX

f. Other (Specify)

FORMCHECKBOX

g. Female

FORMCHECKBOX

h. Male

FORMCHECKBOX

i. 8(a) Certified (Certification letter attached) FORMCHECKBOX

j. Service Disabled Veteran Small Business

Is the person identified in Number 4 above, responsible for day-to-day management and policy decision making, including but not limited to financial and management decisions?

FORMCHECKBOX

a. Yes

FORMCHECKBOX

b. No (If “NO,” provide the name and telephone number of the person who has this authority.)

Nature of Business (Specify all services/products (NAIC))

(a) Years the firm has been in business

(b) No. of Employees

Type of Ownership:

FORMCHECKBOX

a. Sole Ownership

FORMCHECKBOX

b. Partnership

FORMCHECKBOX

c. Other (Explain)

10.

Gross receipts of the firm for the last three years:

a.1. Year Ending:

b.1. Gross Receipts

a.2. Year Ending:

b.2. Gross Receipts

a.3. Year Ending:

b.3. Gross Receipts

11.

Is the firm a small business?

FORMCHECKBOX

a. Yes

FORMCHECKBOX

b. No

12.

Is the firm a service disabled veteran owned small business? FORMCHECKBOX

a. Yes

FORMCHECKBOX

b. No

13.

Is the firm a socially and economically disadvantaged small business? FORMCHECKBOX

a. Yes

FORMCHECKBOX

b. No

I DECLARE THAT THE FOREGOING STATEMENTS CONCERNING

ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF. I AM AWARE THAT I AM SUBJECT TO CRIMINAL PROSECUTION UNDER THE PROVISIONS OF 18 USCS 1001.

14. a. Signature

b. Date:

c. Typed Name

d. Title:

List NAICS Code(s) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

ATTACHMENT 2

OMB Control No. 2120-0595 FAA Template No. 61 (rev. 10/08)

File details come from the government source that posted it. Updated Nov 14, 2017.