SBU Information Request Form.docx

DOCX document 17 KB Posted

Attached to
Mayaguez Marine Unit New Construction (Amended 0001)
Solicitation number
47PA0322R0015
Issued by

About this file

This document contains a federal solicitation notice and Sensitive But Unclassified (SBU) information request form. The General Services Administration (GSA) Public Buildings Service is seeking a single firm fixed-price contract for new construction of a marine support administrative building, boat maintenance/storage hangar, exterior parking spaces, and outdoor lighting at a property located in Balneario de Boqueron in Cabo Rojo, Puerto Rico. The work will also include physical security equipment and infrastructure such as CCTV, intrusion detection systems, perimeter fencing, and secure entry. The total estimated value of construction is between $5-10 million. Offerors must submit price and technical proposals by July 28, 2022 at 4:00 PM Central Time via email. This requirement is a total small business set aside with a North American Industry Classification System code of 236220 and small business size standard of $39.5 million. Access to SBU documents requires completion of a request form and verification of business information.

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{This form is for the offeror’s/contractor’s use if drawings or other sensitive but unclassified building information will be requested by the offeror/contractor.}

REQUEST FOR SENSITIVE BUT UNCLASSIFIED BUILDING (SBU) INFORMATION

Solicitation/Contract Number ________________________________________

The requester shall complete the information below and return the entire Request for Sensitive but Unclassified Building (SBU) Information document to the Contracting Officer or Contract Specialist. By signature below, the requestor of SBU building information acknowledges the requirement to maintain controls, as stated herein, to safeguard the information, and shall return or destroy the SBU building information as required by this Agreement. The undersigned acknowledges that the requester shall abide by this Agreement and shall only disseminate SBU building information to other authorized users under the conditions set forth herein.

Company Name: _____________________________________________________

Name of Individual and Title: ____________________________________________

Signature: ___________________________________________________

Date: _______________________________________________________

(The Offeror shall attach copy of business license or formation document.)

Unique Entity ID (UEI) (formerly DUNS) Number: _____________________________

UEI Number Verified by Government Representative at: https://www.sam.gov/portal/public/SAM/#1 Yes: ___ No: ___

Employer ID Number/Federal Tax ID Number _______________________________

Offeror/bidder/contractor information and DUNS number has been verified and release of SBU building information is approved by:

_____________________________________________________________
[Contracting Officer's Name]Date

Contracting Officer This statement shall be submitted by the holder of SBU building information when information is disposed of in accordance with the Request for Sensitive but Unclassified Building Information upon completion of the Project.}

DISPOSAL STATEMENT FOR SENSITIVE BUT UNCLASSIFIED BUILDING INFORMATION

Solicitation/Contract Number ________________________________________

I hereby certify that all Sensitive but Unclassified (SBU) building information relative to the referenced solicitation/contract not previously returned to the Government has been destroyed or disposed of by burning or shredding paper copies, physically destroying computer diskettes or permanently deleting/removing/erasing electronic files from computers.

I also certify the no unauthorized physical or electronic copies of such SBU building information were made or are being retained.

Company Name: ______________________________________________

Name of Individual: ____________________________________________

Signature: ___________________________________________________

Title: _______________________________________________________

Date: _________________

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