Response Form to Sources Sought Notice.pdf
PDF 161 KB Posted
- Solicitation number
- 36C26325Q0249
About this file
This is a Sources Sought response form for Medical Instrument Technician (MIT) Echosonographer Services at the Minneapolis VA Health Care System. The form requests company information including name, address, SAM UEI number, point of contact details, and socio-economic classification under NAICS code 561320 (Temporary Help Services).
The form includes checkboxes for various business classifications including Small Business, SDVOSB, VOSB, Women-owned Small Business, HUBZone, and 8(a) Certified businesses. It also requires respondents to indicate the percentage of services they would perform as Prime Contractor versus subcontract to other firms. This response form is part of a Sources Sought notice seeking potential contractors to provide 2.0 FTE certified MIT Echosonographers, with responses due by December 16, 2024, at 10:00 AM Central Time. The form must be submitted along with a capability statement to Nicole Burski at the VA.
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Other files
| File | Type | Posted |
|---|---|---|
| PERFORMANCE WORK STATEMENT.pdf | ||
| 36C26325Q0249.docx | DOCX document |
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Text version
Sources Sought Information and Capabilities for
Medical Instrument Technician (MIT) Echosonographer Services
Please fully complete each section of the form below.
Company Name: _____________________________________________________________
Company Address: ___________________________________________________________
SAM UEI Number: _____________________________________________________________
Point of Contact: ____________________________________________________________
Phone Number: _____________________________________________________________
Email Address: _____________________________________________________________
Socio-economic Classification in Accordance with NAICS Code 561320 Temporary Help Services
(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
Estimated Services to be Subcontracted
•What percentage of services (estimated) would the company perform as the Prime
Contractor? __________________%
•What percentage of services (estimated) would the company subcontract to other firms?__________________%
File details come from the government source that posted it. Updated .