J-14-EEOCClearanceRequestInfo.doc
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Final RFP Section J Attachment 14 DOL EEOC Clearance Request Information
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Attachment J-14: DOL EEOC Clearance Request Information DOL EEOC Clearance Request Information
| VENDOR IDENTIFICATION |
| Prime Contractor |
| Yes No |
| Subcontractor |
| Yes No |
Full name of vendor:
| Central Contractor Registration (CCR) |
| Cage Code: |
DUNS number
Vendor name as it appears in CCR:
Physical address as it appears in CCR:
| CONTRACT PERFORMANCE |
| List place(s) of performance with reference to subject proposed work |
| Place(s) of Performance: |
| Number of employees at this site: |
| Previous Government contracts performed from this site: |
Yes No
Yes No
Yes No
Yes No
POINT OF CONTACT
Point of contact for DOL EEOC clearance issues
Name and title
Telephone and fax numbers
Email address
PROPOSED AWARD AMOUNTS
List proposed award amounts
| Base year |
| $ |
| Option year five |
| $ |
| Option year one |
| $ |
| Option year six |
| $ |
| Option year two |
| $ |
| Option year seven |
| $ |
| Option year three |
| $ |
| Option year eight |
| $ |
| Option year four |
| $ |
| Option year nine |
| $ |
| Total base plus all option periods award amount |
| $ |
| CORPORATE AFFILIATES |
| List the name, address, POC and telephone number of all corporate affiliates |
| 1 |
| 4 |
| 2 |
| 5 |
| 3 |
| 6 |
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