Telecom Response Template.doc

Defense Security Service – DSS

Telecom Response Template

RFQ HS0021-11-F-0096

General Information

Company Name:

DUNS:

Address:

Years of Experience doing tasks in the SOW:

Years of Experience doing similar tasks for the Federal Government:

Years of Experience doing similar tasks for the DoD:

1Managed Multiple locations for the same entity: FORMCHECKBOX Yes FORMCHECKBOX No

Specific Experience and Past Performance References (Note: DoD and Federal Government experience is considered more relevant) Specific Experience (1) Agency or Company:

Contract Number (if applicable):

Period of Permance:

Narrative of Work Performed:

Point of Contact:

Position within the Entity:

Telephone Number:

Email:

Specific Experience (2)

Agency or Company:

Contract Number (if applicable):

Period of Permance:

Narrative of Work Performed:

Point of Contact:

Position within the Entity:

Telephone Number:

Email:

Specific Experience (3)

Agency or Company:

Contract Number (if applicable):

Period of Permance:

Narrative of Work Performed:

Point of Contact:

Position within the Entity:

Telephone Number:

Email:

Solution Summary

Local Service Carrier:

Long Distance Service Carrier:

Final Submission Acknowledgement of Amendments as of Response Date (if any):

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Amendment 0001

Title of Amendment:

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Amendment 0002

Title of Amendment:

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Amendment 0003

Title of Amendment:

Terms and Conditions:

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Agree to all terms and conditions set forth in RFQ HS0021-11-F-0096

Checklist of Required Documents:

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Telecom Response Template

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Telecom Pricing Template

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Representations and Certifications (Note: Even if you have an ORCA record you must fill out Section b of the document and submit it. Additionally, if the total award (including all options) is expected to exceed $150,000 you myst fill out the DoD representations and certifications at the end of the template.

1If this question is answered affirmatively, then list this work as one of your experience/past performance references. If the work of managin multiple offices for a single entitiy involves contract numbers enter “multiple” instead of an actual contract number.

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