SAM Sources Sought Response Form.docx

DOCX document 15 KB Posted

Attached to
Hazardous Waste Disposal for the Hawaii Air National Guard
Solicitation number
W50SLF26X1BTZ
Issued by

About this file

This is a Sources Sought Response Form template designed for vendors to submit information regarding their qualifications and capabilities in response to a pre-solicitation market research notice. The form is specifically created for the Hawaii Air National Guard's anticipated Hazardous Waste Disposal requirement, designated NAICS Code 562211 (Hazardous Waste Treatment and Disposal) with a $47.0 million size standard.

Respondents must complete all sections of the form, including company registration details in the System for Award Management (SAM), Commercial and Government Entity (CAGE) code, and Unique Entity ID (UEI) number. The form requires vendors to identify their socioeconomic status by selecting all applicable categories, which may include small business, small disadvantaged business, 8(a) program participant, HUB Zone business, woman-owned business, or Service-Disabled Veteran-Owned Small Business (SDVOSB). Vendors must provide a capabilities statement demonstrating their qualifications to perform hazardous waste disposal services and include GSA contract or other GWAC information if applicable. The form includes a certification statement requiring vendors to confirm SAM registration and socioeconomic status accuracy. A point of contact must be identified with phone and email information. Incomplete submissions may result in exclusion from the Government's consideration for set-aside procurement decisions. The anticipated requirement is for a five-year Blanket Purchase Agreement (BPA) for hazardous waste disposal services at Joint Base Pearl Harbor Hickam, with the Product Service Code F108 (Environmental Systems Protection—Environmental Remediation).

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SAM Sources Sought Response Form.pdf PDF
Attachment 1 - Estimated Workload Data.pdf PDF

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Text version

Sources Sought Response Form NAICS Code: ___________ Interested firms please respond with this information form and the following requested information. Please complete all sections of the document.

Company Information: _________________ Company Name: __________________ Company Address as registered in System for Award Management (SAM): _________________ Commercial and Government Entity (CAGE) Code: ________________ Unique Entity ID (UEI) Number: ___________________ Socio‐economic status for the listed NAICS code ‐ please check all that apply:

( ) Large business( ) Small business
() Small disadvantaged business( ) 8(a) program participant
( ) HUB Zone business( ) Woman‐Owned business
() Service‐Disabled Veteran‐Owned Small Business (SDVOSB)

By responding to the Sources Sought Notice, I confirm that my firm is registered in the System for Award Management (SAM) https://www.sam.gov/ with the socio‐economic status identified above and the NAICS code specified in the sources sought notice; or that my firm qualifies and registration under the applicable NAICS code is in process.

Capabilities Statement:

Certification:

I understand that incomplete answers in sections or my failure to provide required documentation or failure to sign this certification may remove my firm from the Government’s determination of whether to solicit the referenced project on a set-aside basis in accordance with Part 19 of the Federal Acquisition Regulation.

Vendor Name: ___________________________________________________ Vendor POC: ___________________________________________________ Contact Ph#: _____________________________________________________ Fax and/or Email: ___________________________________________________ GSA Contract, or other GWAC information: ____________________________________ Signature: __________________________________

File details come from the government source that posted it. Updated .