Sources_Sought_Info_Form_FINAL_Refuse.docx

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Integrated Solid Waste Management Services at Marine Corps Base (MCB) Camp Butler, Okinawa, Japan
Solicitation number
N40084-14-R-0072
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Enclosure 1 Sources Sought- Contractor Information Form

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AMD_0002_14R0072_Sources_Sought.pdf PDF
14R0072_Amend0001_Sources_Sought.pdf PDF

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SOURCES SOUGHT – CONTRACTOR INFORMATION FORM (Part I) Integrated Solid Waste Management Services at Marine Corps Base (MCB) Camp Butler, Okinawa, Japan

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

1. Contractor Information:

Firm Name:
Address:
Name of POC for firm:
Phone Number of POC:
Email of POC:

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

|_| Large Business |_| Small Business

System for Awards Management (SAM) Information:

DUNS: _____________________________________

CAGE: _____________________________________

3. List of Relevant Projects

4. This space may be used to provide any additional information to clarify the above items only:

Please DO NOT change content of the form.

(Rev. 03/13)

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM (Part II) Integrated Solid Waste Management Services at Marine Corps Base (MCB) Camp Butler, Okinawa, Japan

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 3 projects. Please limit response to two pages per project.

1.
Contractor Name:
2.
Project No. (check one):
|_| - 1|_| - 2|_| - 3
3.
Contract Number:
Delivery/Task Order No.:
Project Number:
Title:
Location:
4.
Award Date (mm/dd/yy):
5.
Final Contract Price:
$
Completion Date (mm/dd/yy):
(incl. all options and mods)
Project is on the period or completed on
This is the |_| total project |_| subcontract price.
6.
Type of work:
|_| Solid Waste Collection |_| Other (explain): ____ _____________
7.
Customer/Owner Name:
Point of Contact Name/Title: (person with project knowledge)
POC Phone Number:
POC Email Address:
8.
Were you the Prime contractor for this project?
|_| Yes|_| No
Were you a subcontractor for this project?
|_| Yes|_| No
If subcontractor, who was the Prime contractor?
9.
Type of Contract (check all that apply):

|_| Firm-Fixed Price/ IDIQ

|_| Other (explain):

10. Narrative Description of the Project:

11. Percentage of work you self-performed on this project: %. Explain work self-performed:

Form may be expanded. Please DO NOT change content of the form.

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