J.4 HCaTS SB Pool Application and Certification A03.xlsm
XLSM spreadsheet 37 KB Posted
- Solicitation number
- GS02Q15CRR0002
- Issued by
-
GSA Federal Acquisition Service
About this file
This document contains a pool application and certification form for the Human Capital and Training Solutions Small Business (HCaTS SB) solicitation. The form requests background information on the offeror including name, address, DUNS number, and socioeconomic status. It requires selection of one or both pools under the solicitation, with size standards of $11 million for Pool 1 and $15 million for Pool 2. NAICS codes covered include professional and management training, vocational rehabilitation, administrative consulting, and human resources consulting. Key contractor personnel names and titles must be provided. By submitting the form, offerors agree to terms and conditions including accepting performance standards and acknowledging the government's right to invoke dormant status or off-ramp procedures for non-performance. It certifies various small business categories and designations.
The related federal contract opportunity notice announces that on or about May 19, 2015, the General Services Administration will issue two requests for proposals for the Human Capital and Training Solutions contracts as the successor to the Training and Management Assistance contracts. One will be unrestricted and the other a total small business set-aside. Multiple awards are anticipated for governmentwide indefinite delivery, indefinite quantity task order contracts. Comments on the attached draft RFP for the small business set-aside were due by March 30, 2015. The final RFPs will be posted at GS02Q15CRR0002.
HCaTS SB Attachment J.4 (Pool Application and Certification) A03
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Text version
Pool Application Pool Application and Certification Human Capital and Training Solutions Small Business (HCaTS SB)
Solicitation Number: GS02Q15CRR0002 Attachment J.4 Amendment #: 03 All sections must be completed before submission.
| SECTION I - BACKGROUND |
| A. Offeror Information: The Offeror shall provide herein this Section I its official Name, Address, and DUNS Number of the bidding entity as specified on the SF33 and for which the Offeror has a corresponding active profile at www.sam.gov. |
| Offeror Name: |
| Offeror Address: |
| DUNS Number: |
| Entity Type: |
B. Entity Size Status: If an Offeror is Other than Small Business, leave this section blank. If the Offeror is a Small Business, the Offeror shall select the applicable socio-economic subgroup(s) it certifies itself as for purposes of this Solicitation. The Offeror's SAM record shall reflect the same selections.
C. Authorized Representative: The Offeror shall indicate the individual with authority to commit and bind the Offeror for purposes of this Solicitation.
| Name: |
| Title: |
| Office Phone: |
| Mobile Phone: |
| Email: |
| D. Alternative Authorized Representative: The Offeror shall indicate an alternative point of contact who shall also have the authority to commit and bind the Offeror for purposes of this Solicitation. |
| Name: |
| Title: |
| Office Phone: |
| Mobile Phone: |
| Email: |
| SECTION II - HCaTS POOL QUALIFICATION | |
| Pool Selection: The Offeror shall indicate which Pool(s) it seeks consideration for purposes of this Solicitation. | |
| POOL 1 - Size Standard $11M | POOL 2 - Size Standard $15M |
NAICS:
611430 (Professional & Management Development Training) 611699 (All Other Miscellaneous Schools and Instruction) 624310 (Vocational Rehabilitation Services) NAICS:
541611 (Administrative Management and General Management Consulting Services) 541612 (Human Resources Consulting Services) 541613 (Marketing Consulting Services) 541618 (Other Management Consulting Services) 611710 (Educational Support Services)
| Contractor Key Personnel #1 | ||
| (Corporate HCaTS Program Manager): | Contractor Key Personnel #1 |
(Corporate HCaTS Program Manager):
| Name: | Name: | ||
| Title: | Title: | ||
| Contractor Key Personnel #2 | |||
| (Corporate HCaTS Contract Manager): | Contractor Key Personnel #2 |
(Corporate HCaTS Contract Manager):
| Name: | Name: |
| Title: | Title: |
| SECTION III - CERTIFICATIONS/AUTHORIZATIONS |
| BY SUBMITTING THIS FORM, OFFEROR AGREES TO AND ACKNOWLEDGES THE FOLLOWING TERMS AND CONDITIONS: |
1) Offeror accepts all Terms, Conditions, Provisions, and Clauses included in the solicitation.
2) Offeror accepts the performance standards identified in Section F.5, and acknowledges that it is the Government’s unilateral right to invoke Dormant Status or Off-Ramp procedures for failure to meet the stated standards.
3) The Price proposal reflects the Offeror's rates and estimates as of the date of proposal submission. By submitting this proposal, the Offeror grant the Contracting Officer and Authorized Representative(s) the right to examine, at any time before award, those records, which include books, documents, accounting procedures and practices, and other data, regardless of type and form or whether such supporting information is specifically referenced or included in the proposal as the basis for pricing, that will permit an adequate evaluation of the proposed price in accordance with FAR Subsection 15.403-3.
4) Offeror acknowledges that the falsification of any proposal submission, documents or statements may subject the Offeror to civil or criminal prosecution under Section 1001 of Title 18 of the United States Code.
Small Business HUBZone Small Business Service Disabled Veteran Owned Small Business 8(a) Small Business Economically Disadvantaged Woman Owned Small Business Woman Owned Small Business The Offeror identifies as small business for Pool 1.
The Offeror identifies as small business for Pool 2.
ImportSheet
| Offeror Name | Offeror Address | DUNS | Individual | CTA | SB | SDVOSB | EDWOSB | HUBZone | 8(a) | WOSB | Name | Title | O.Phone | M.Phone | Name | Title | O.Phone | M.Phone | Pool 1 | SB Pool1 | Pool 2 | SB Pool 2 | CKP#1 Name | CKP#1 Title | CKP#2 Name | CKP#2 Title | CKP#1 Name | CKP#1 Title | CKP#2 Name | CKP#2 Title | Yes | ||
| 0 | 0 | 0 | FALSE | FALSE | FALSE | FALSE | FALSE | FALSE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | FALSE | FALSE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | FALSE |
Not applicable, for Evaluation purposes.
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