Attachment_V_-_Business_Management_Questionnaire.pdf

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Medical Claims Adjudication
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RFP-P0700NAS-14-0092
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Attachment V - Business Management Questionnaire

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Attachment_VI_-_Bank_Letter.pdf PDF
Attachment_IV_-_Subcontracting_Plan.pdf PDF

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ATTACHMENT V

BUSINESS MANAGEMENT QUESTIONNAIRE

1. Provide the work distribution, by percentage, among commercial contracts and Government contracts (including prime and subcontracts):

COMMERCIAL:_________percent GOVERNMENT:_________percent

2. List the last three contracts awarded to your firm which are of a related nature, indicating for each the following:

Contract 1

(a) Customer & Address _____________________________

(Phone) _____________________________

(b) Contract Number _____________________________

(c) Person to Contact______________________________

Phone: ______________________________

Email:_____________________________

(d) Type of Work _____________________________

(e) Amount of Contract $_____________________________

(f) Contract Status [__] Active [__] Complete

Contract 2

(Phone) _____________________________

(b) Contract Number _____________________________

(c) Person to Contact______________________________

Phone: ______________________________

Email:_____________________________

(d) Type of Work _____________________________

(e) Amount of Contract $_____________________________

Contract 3

(Phone) _____________________________

(b) Contract Number _____________________________

(c) Person to Contact______________________________

Phone: ______________________________

Email:_____________________________

(d) Type of Work _____________________________

(e) Amount of Contract $_____________________________

3. Bank Reference Information:

ATTACHMENT V

(a) Name of Bank _____________________________________

(b) Address _____________________________________

(c) Person to Contact ________________________________

Phone:

Email:________________________________________

4. Total estimated amount of work under this contract that your firm will complete (excluding subcontractors): _______percent

5. Please provide your DUNS (Data Universal Numbering System) number:

6. If applicable, please provide your Parent Company's DUNS: ______________________

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