ATTACHMENT A CONTRACTOR INFORMATION FORM.docx

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

for Architect- Engineer IDIQ Contract Naval Surface Warfare Command Carderock

Use this form to provide contractor’s general information. Please limit response to one page. The box at the bottom of this form may be used to clarify any requested information. Upload to FedBizOps

CAGE Code* :

Firm Name:

Address:

Name of POC for firm:

Phone Number of POC:

Email of POC:

2. Type of Business: (check all that apply)

|_| Small Business

|_| SBA certified HUBZone Small Business

|_| Service-Disabled Veteran-Owned Small Business

|_| Small Disadvantaged Business

|_| SBA certified 8(a) firm

|_| Women-Owned Small Business

3. Bonding Capacity:

Surety Name:

Maximum bonding capacity per project:

Aggregate maximum bonding capacity:

4. Locations. Identify the locations you are willing and capable to work: (check all that apply)

|_| Naval Surface Warfare Center Carderock, Division 9500 MacArthrur Blvd, West Bethesda, Maryland

|_| Naval Surface Warfare Center-Carderock Division Olney Support Facility 5321 Riggs Road, Gaithersburg, MD 20882

|_| Acoustic Research Detachment 33964 N. Main Avenue Bayview, ID 83803

|_| Naval Surface Warfare, Carderock Division, Southeast Alaska Acoustic Measurement Facility 1 Back Island Ketchikan, AK 99901

|_| Naval Surface Warfare Center, Carderock Division Detachment, Large Cavitation Channel 3001 Harbor Ave Memphis, TN 38113

|_| Combatant Craft Division 1052 Pocahontas Drive, Bldg. V-47 Norfolk, VA 23511

|_| Acoustic Trials Detachment Titusville, FL

|_| Naval Surface Warfare Center, Carderock Division Detachment Puget Sound 7131 Sea Lion Road Naval Base Kitsap Bangor Silverdale, WA 98315

|_| South Florida Ocean Measurement Facility, Naval Surface Warfare Center, Carderock Division 91 North Beach Rd.

Dania Beach, FL 33004

5. Is your company currently registered in System of Award Management (SAM)? Yes |_| No |_|

6. Clarifications/Comments:

*DUNS & Cage Code are required for this submission and will be required for proposal submission

(Rev. 11/15)