J11._OFCCP_EEOC_Clearance_Request_Info.doc

DOC document 48 KB Posted

Attached to
USSTRATCOM Command and Control Facility, Furnishings Fit-out Federal contract opportunity
Solicitation number
FA4600-15-R-0013
Issued by
Department of the Air Force Air Combat Command

About this file

Attachment 11 DOL OFCCP EEOC Clearance Request Information form

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Text version

FA4600-15-R-0013

Attachment 11

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:

System for Award Management (SAM)
Cage Code:

DUNS number

Vendor name as it appears in SAM:

Physical address as it appears in SAM:

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 three
$
Option year one
$
Option year four
$
Option year two
$
Six-month Extension
$
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 .