DTFH61-12-R-00057 Attachment No. 9 Cover Sheet.pdf

DTFH61-12-R-00057

Attachment No. 9

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Proposal Cover Sheet

S ol ic it at io n Number: DTFH61-12-R-00057

Title: “Pavement Materials Laboratories”

Closing Date: 4:00 pm EST October 9, 2012 Negotiator: Lise S. Lyles

O ff er or

Name:

U.S. Postal Address: Federal Express Address:

Address:

P oi n t( s) o f

C on ta ct

Primary Alternate

Name:

Title:

Telephone #:

Facsimile #:

E-mail:

St at em en t

Include a statement in accordance with FAR 52.215-1(c)(2)(iii):

A ut ho ri ze d

N eg ot ia to r( s)

Name & Title Telephone # Facsimile # E-mail Address:

P ro p os al

Si gn at ur e

Name & title of person authorized to sign the proposal. Signature Date

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The Proposed Team Summary:

Check the appropriate box(es)

Business Size / Type

Input the below information for the prime Contractor and each subcontractor or consultant:

Size 4 Types 4

Minority Institutions 4

Name, Address, Point of Contact & Phone Number DUNS # 1 Cost/Price 2 Profit/Fee 2 Total 2

Contract Type 3 L

B

D

8( a)

V

W

H

C

U

I A

II

I

Subtotals:

TOTAL:

1 Dun & Bradstreet’s Data Universal Numbering System (DUNS) 2 Includes base period and all options (if any). Include Cost/Price and Profit/Fee breakdown for subcontractors/consultants if known.

3 Contract Type: (FFP / FPI / CPFF / CPIF / CPAF / IDIQ / OTHER) 4 Business Representation in accordance with RFP Section K, FAR 52.204-8 and FAR 52.219-1

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L eg en d

Size Types Minority Institutions

LB Large Business SDB Small Disadvantaged Business Concern HBCU Historically Black Colleges and Universities

SB Small Business 8(a) Small Business Administration 8(a) Program HSI Hispanic Serving Institutions

VO Veteran Owned AIIHL American Indian Institutions of Higher Learning

WO Woman-Owned Business Concern