Section_J _Attachment_16 _OFCCP_clearance_request_documentation.doc

DOC document 49 KB Posted

Attached to
Information Technology Capabilities Contract (ITCC) II
Solicitation number
FA4600-14-R-0017
Issued by

About this file

This document is an OFCCP clearance request form for a vendor proposing on solicitation number FA4600-14-R-0017 for the Information Technology Capabilities Contract (ITCC) II in support of United States Strategic Command. The form requires vendors to provide their CCR registration, DUNS number, physical address, place of performance, number of employees, previous government contracts at that site, and point of contact for OFCCP clearance issues. Vendors must also list proposed award amounts for the base year and each option year, as well as the total award amount. Finally, vendors must provide the names, addresses, points of contact, and phone numbers for all corporate affiliates.

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Text version

FA4600-14-R-0017

Section J, Attachment 16

DOL OFCCP EEOC Clearance Request Information Form

Complete for each vendor with prime or subcontractor status in subject proposal

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 three
$
Option year four
$
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

File details come from the government source that posted it. Updated .