Information Request Form_Sources Sought.docx

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Advertising Campaign, Virginia Air National Guard
Solicitation number
W50S9B21Q0015
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INFORMATION REQUEST FORM

NAICS Code: 541810

Interested firms please respond with this information form and the following requested information. Please complete all sections of the document.

1. Company Information.

Company Name:

Company Address as registered in System for Award Management (SAM):

CAGE Code:

DUNS Number:

Socio-economic status for the listed NAICS code - please check all that apply:

( ) Large business ( ) Small business

() Small disadvantaged business() 8(a) program participant
() HUB Zone business() Woman-Owned business
() Service-Disabled Veteran-Owned Small Business (SDVOSB)

2. Point of Contact.

Name:

Email:

Contact No.:

By responding to the Sources Sought Notice, I confirm that my firm is registered in the System for Award Management (SAM) https://www.sam.gov/ with the socio-economic status identified above and the NAICS code specified in the sources sought notice; or that my firm qualifies and registration under the applicable NAICS code is in process.

Name:

Title:

Signature:

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