Attachment_1_(Corporate_Background_Information_Questionnaire).docx

CORPORATE BACKGROUND INFORMATION QUESTIONNAIRE

Company Information

Name of Company:

Mailing Address:

Cage Code:

DUNS Number:

Phone Number:

FAX Number:

Company Point of Contacts

Name of Primary:

Title:

Email:

Fax Number:

Name of Alternate:

Title:

Email:

Fax Number:

NAICS CODE(s):

(circle one)

Government Certifications (Place a check next to all that apply)

8(a) Certified or 8(a) Joint Venture

Small Disadvantaged Business

Hubzone Certification

Ownership and Self-Certifications (Place a check next to all that apply)

Any Minority Owned:

__ Any Native American Owned:

__ Tribally Owned __ Alaskan Native Corp Owned __ Native Hawaiian Org Owned __ Other Native American __ Other Minority Owned

Any Women-Owned Small Business:

__ Women-Owned Small Business under the Women-Owned Small Business Program __ Economically Disadvantaged Women-Owned Small Business under the Women-Owned Small Business Program __ Women-Owned Small Business Joint Venture __ Economically Disadvantaged Women-Owned Small Business Joint Venture

Community Development Corporation (CDC) Owned

Service Disabled Veteran-Owned

Self-Certified Small Disadvantaged Business

Veteran Owned (including Service Disabled Veteran Owned)

REQUEST FOR INFORMATION

NAVY'S CORROSION SURVEILLANCE PROGRAM ON GUAM

CORPORATE BACKGROUND INFORMATION QUESTIONNAIRE

CORPORATE BACKGROUND INFORMATION QUESTIONNAIRE

(continued)

CSPG RFI, Attachment 1 v19-10-31 Page 1 of 5 Specific information NAVFAC is seeking:

1Q. Does your company have, or can secure the personnel to support a corrosion surveillance program for naval construction equipment and support vehicles?

1A. Circle either YES or NO

2Q. Does your company have, or can secure the personnel and facilities to support the corrosion mitigation of the naval construction equipment and support vehicles?

2A. Circle either YES or NO

3Q. Does your company have, or can secure the facilities to support the corrosion repair of the naval construction equipment and support vehicles?

3A. Circle either YES or NO

4Q. Does your company regularly engage in the business of vehicle/equipment paint and bodywork; to include corrosion mitigation, paint preparation, body repairs, and painting?

4A. Circle either YES or NO

5Q. If answer to Question 4 was yes, how long has your company provided these services?

5A. __________________________________________________________________

6Q. Has your company performed paint and bodywork services on heavy construction equipment?

6A. Circle either YES or NO

7Q. If answer to Question 6 was yes, what is the percentage of paint and bodywork your company performed on heavy construction type equipment during the last two calendar years.

7A. 2018: ____________________________________________________________

2019: ____________________________________________________________

8Q. Does your company have, or can secure facilities designed to protect personnel (in accordance with OSHA guidelines) during the entire paint process while also protecting the primer and paint application process from the environment?

8A. Circle either YES or NO

9Q. If answer to Question 8 was yes, please describe your facility(ies) (i.e. paint booth, blasting area, capacity of shop, and size of work force), this can be provided on a separate sheet of paper if necessary.

9A. __________________________________________________________________

10Q. If answer to Question 8 was yes, please provide the dimensional data for the largest piece of equipment your facility can accommodate.

10A. _________________________________________________________________

11Q. Has your company worked with relevant Military Standards before?

11A. Circle either YES or NO

12Q. If answer to Question 11 was yes, please list the most relevant Military Standards utilized.

12A. _________________________________________________________________

13Q Has your company worked with Chemical Agent Resistant Coating (CARC) paint before?

13A. Circle either YES or NO

14Q. If necessary, can your company support a surge event? A surge event is a rapid increase in work flow in response to world events, to possibly include processing more equipment and/or expedited services.

14A. Circle either YES or NO

15Q. If applicable, on a separate piece of paper please list any contracts your company is currently performing that would be considered the same as or similar to this effort (size, scope, complexity). In addition, please include any you may have completed within the last five years.

Please include:

(a) Name of Contracting Activity,

(b) Contract type (FFP, cost, IDIQ, or Combination),

(c) Period of Performance,

(d) Basic Contract Award Amount with Options,

(e) Contract Value Per Year,

(f) Current/Final Contract Amount,

(g) Summary of Contract Work,

(h) Contracting Officer Name and Current Telephone Number, and

(i) List of Major Subcontractors including name, address, and telephone number of primary point of contact.

16Q. Does your company normally submit a proposal as its own business entity or as a Joint Venture when competing for this type of work?

16A. Circle either Own Business Entity or Joint Venture

17Q. If competing as a Joint Venture, list those firms with whom you are affiliated.

17A. _________________________________________________________________

18Q. For Small Businesses, please identify your business type (See notes (1) and (2) below):

___ HUBZone Small Business

19Q. Should the solicitation be set-aside for Small Business, will the Small Business be able to meet the FAR 52.219-14, LIMITATIONS ON SUBCONTRACTING (i.e.: at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern)?

19A. Circle either YES or NO

NOTE:

(1) Please mark all categories under which your company qualifies. To qualify as an 8(a), Small Disadvantaged or HUBZone Small Business, your company must be certified by the Small Business Administration.

(2) The Government recognizes the integrity and validity of team arrangements (including joint-ventures) to act as potential prime contractors (FAR 9.601). However, some affiliation rules apply to small business joint ventures in order to maintain their small business status. Please refer to FAR Part 19, 13 CFR 124, and 13 CFR 126.

(3) All data received in response to this Source Sought Notice marked or designated, as corporate or proprietary information will be fully protected from release outside the Government.

Additional Comments: _________________________________________________

CSPG RFI, Attachment 1 v19-10-31 Page 7 of 5