Response Form to Sources Sought Notice.pdf

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Attached to
H112--Fire Alarm Testing/Inspection Central Iowa VAHCS POP: 03-01-2025 to 02-28-2026 4
Solicitation number
36C26325Q0306
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About this file

This is a Sources Sought response form template associated with a fire alarm testing/inspection services opportunity at the Central Iowa VA Healthcare System. The form requests basic company information including name, address, DUNS number, point of contact details, and socio-economic classifications.

The form includes checkboxes for various small business categories including Service Disabled Veteran Owned, Veteran Owned, Women-owned, HUBZone, 8(a), and others, with verification requirements noted for SDVOSB and VOSB through www.vip.vetbiz.gov. It also requires respondents to specify the percentage of work they would perform as prime contractor and the percentage they would subcontract. The associated sources sought notice has a response deadline of January 7th, 2025 at 10:00 AM Central Time, with responses to be submitted to the VA contracting specialist via email. The period of performance for the potential contract would be March 1, 2025 to February 28, 2026.

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Text version

Sources Sought Information and Capabilities

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 (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 ☐ Other: _________________________________________________

Detailed Information:

1. What percentage of the contracted services can your company complete as the prime contractor? ______________%

2. What percentage of the contracted services would your company subcontract?

http://www.vip.vetbiz.gov/ http://www.vip.vetbiz.gov/

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