Encl1ContractorInfo.pdf

(Rev. 03/13)

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

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.

1. Contractor Information:

Firm Name:

Address:

Name of POC for firm:

Phone Number of POC: Email of POC:

DUNS: CAGE:

2. This space shall be used to provide any professional qualifications information that is relevant:

(Please describe your accreditation/certification for the various environmental sampling and testing.)

3. Geographical Locations:

Has your company performed in or for the geographic as listed in the Scope of Work?

Yes No

Confirm if you have one or multiple office locations in Japan, Republic of Korea, and Singapore and with laboratory analytical services can be executed at each geographic office.

Japan

Republic of Korea (Chinhae and Busan)

Drinking Water

Other Services

Singapore

Drinking Water

Other Services

4. Proposal: what is the likelihood your firm proposing on this contract?

High Low

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

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 5 projects. Please limit response to two pages per project.

1. Contractor Name:

2. Project No. (check one): - 1 - 2 - 3 - 4 - 5

3. Contract Number: Delivery/Task Order No.:

Project Number:

Title:

Location:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Project is % complete (on submission due date)

5. Final Contract Price: $

(incl. all options and mods)

This is the total project subcontract price.

6. Customer/Owner Name:

Point of Contact Name/Title:

(person with project knowledge)

POC Phone Number: POC Email Address:

7. 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?

8. Type of Contract (check all that apply):

Firm Fixed-Price (FFP) Indefinite Delivery / Indefinite Quantity (IDIQ)

Other (explain):

If partnership, provide the following information:

Partner firm name: Years working together:

Address:

9. Narrative Description of the Project:

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

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 5 projects. Please limit response to two pages per project.

1. Contractor Name:

2. Project No. (check one): - 1 - 2 - 3 - 4 - 5

3. Contract Number: Delivery/Task Order No.:

Project Number:

Title:

Location:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Project is % complete (on submission due date)

5. Final Contract Price: $

(incl. all options and mods)

This is the total project subcontract price.

6. Customer/Owner Name:

Point of Contact Name/Title:

(person with project knowledge)

POC Phone Number: POC Email Address:

7. 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?

8. Type of Contract (check all that apply):

Firm Fixed-Price (FFP) Indefinite Delivery / Indefinite Quantity (IDIQ)

Other (explain):

If partnership, provide the following information:

Partner firm name: Years working together:

Address:

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 5 projects. Please limit response to two pages per project.

1. Contractor Name:

2. Project No. (check one): - 1 - 2 - 3 - 4 - 5

3. Contract Number: Delivery/Task Order No.:

Project Number:

Title:

Location:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Project is % complete (on submission due date)

5. Final Contract Price: $

(incl. all options and mods)

This is the total project subcontract price.

6. Customer/Owner Name:

Point of Contact Name/Title:

(person with project knowledge)

POC Phone Number: POC Email Address:

7. 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?

8. Type of Contract (check all that apply):

Firm Fixed-Price (FFP) Indefinite Delivery / Indefinite Quantity (IDIQ)

Other (explain):

If partnership, provide the following information:

Partner firm name: Years working together:

Address:

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 5 projects. Please limit response to two pages per project.

1. Contractor Name:

2. Project No. (check one): - 1 - 2 - 3 - 4 - 5

3. Contract Number: Delivery/Task Order No.:

Project Number:

Title:

Location:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Project is % complete (on submission due date)

5. Final Contract Price: $

(incl. all options and mods)

This is the total project subcontract price.

6. Customer/Owner Name:

Point of Contact Name/Title:

(person with project knowledge)

POC Phone Number: POC Email Address:

7. 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?

8. Type of Contract (check all that apply):

Firm Fixed-Price (FFP) Indefinite Delivery / Indefinite Quantity (IDIQ)

Other (explain):

If partnership, provide the following information:

Partner firm name: Years working together:

Address:

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM for

Environmental Testing Services at Various U.S. Navy, Marine Corps, Army and Air Force Bases and Facilities throughout NAVFAC FE AOR (Japan, Republic of Korea

(Chinhae and Busan), and Singapore)

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 5 projects. Please limit response to two pages per project.

1. Contractor Name:

2. Project No. (check one): - 1 - 2 - 3 - 4 - 5

3. Contract Number: Delivery/Task Order No.:

Project Number:

Title:

Location:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Project is % complete (on submission due date)

5. Final Contract Price: $

(incl. all options and mods)

This is the total project subcontract price.

6. Customer/Owner Name:

Point of Contact Name/Title:

(person with project knowledge)

POC Phone Number: POC Email Address:

7. 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?

8. Type of Contract (check all that apply):

Firm Fixed-Price (FFP) Indefinite Delivery / Indefinite Quantity (IDIQ)

Other (explain):

If partnership, provide the following information:

Partner firm name: Years working together:

Address: