NeedipeDIA White Paper Cover Sheet.pdf

NEEDIPEDIA WHITE PAPER COVERSHEET

NOTE: Please include this coversheet as a separate file when submitting white papers to ensure proper routing.

WP Classification: Proprietary Data: Submission Date:

WP Title:

Offeror Organization:

Need or CALL Number:

SAM.gov Unique Entity ID CAGE Code #:

2 Technical POC:

Name: Title:

Phone: Ext: Email:

3 Contract POC:

Name: Title:

Phone: Ext: Email:

4 Mailing Address:

Street: City:

State: Country: Zip:

Physical Address:

(If different from above)

Street: City:

State: Country: Zip:

Organization Descriptors

(Select more than one if applicable)

Large Business Federally Funded Research & Development Center

(FFRDC)

Small Business Intelligence Community Center of Academic Excellence (IC

CAE) or Minority Servicing Institution (MSI) Non-Profit

8(a) Business Program Women-Owned Small Business (WOSB)

HUBZone Service-Disabled Veteran-Owned Small Business (SDVOSB)

Academic Institution/UARC

(University Affiliated Research Center)

Foreign / Offeror not based in US

National Lab Other:

Are you currently working with DIA? Yes No

Have you ever done business previously with the DIA? Yes No

If “yes” – note how recently: Within the last 12 months 1 – 5 years ago Over 5 years ago

Do you have a facility clearance or an integration partnership with another company that has a facility clearance?

Yes No

Level of facility clearance TOP SECRET SECRET

Additional Routing: Is there a US Government POC interested in this submission or topic? Yes No

USG POC 1

(If Not Applicable, Leave blank)

Name: Title:

Phone: Email:

USG POC 2

(If Not Applicable, Leave blank)

Name: Title:

Phone: Email:

List keywords or phrases separated by commas for this submission to aid search and discovery:

10 Filename of Submitted White Paper:

DIA NeedipeDIA Form 002 Version 8.1 – White Paper Cover Sheet