Response Form to Sources Sought Notice.docx

Sources Sought Information and Capabilities for Telecommunication Cable Installation Services

Please fully complete each section of the form below.

Company Name: _____________________________________________________________ Company Address: ___________________________________________________________ DUNS Number: _____________________________________________________________ Point of Contact: ____________________________________________________________ Phone Number: _____________________________________________________________ Email Address: _____________________________________________________________

Socio-economic Classification in Accordance with NAICS Code 811213 Communication Equipment Repair and Maintenance

(check all that apply) ☐ Small Business ☐ Service Disabled Veteran Owned Small Business (SDVOSB) ☐ Verified SDVOSB by www.vip.vetbiz.gov ☐ Veteran Owned Small Business (VOSB) ☐ Verified VOSB by www.vip.vetbiz.gov ☐ Small Disadvantage Business ☐ Women-owned Small Business ☐ Economically Disadvantaged Small Business ☐ HUBZone ☐ 8(a) Certified

% of work to be subcontracted _________________%

Please Attach a Company’s Capability Statement for Communication Equipment Repair and Maintenance Services