Section J_Attachment B - Offeror Information.docx

DOCX document 30 KB Posted

Attached to
Classified and Unclassified Pouch and Mail Services
Solicitation number
19AQMM23R0015
Issued by

About this file

This document contains an offeror information form and details of a federal contract solicitation. The solicitation is for classified and unclassified pouch and mail services in support of the Department of State and other agency customers. Services required include receiving, sorting, pouching, and handling packages and mail, as well as operating government-furnished equipment and complying with transportation, safety, security, and environmental regulations. Offerors must complete the information form providing details such as legal business name, address, website, unique entity identifier, small business designation, and points of contact. Joint ventures must also provide partner information and signed agreements. The solicitation number is 19AQMM23R0015 and was issued by the Department of State Office of Acquisition Management. The contract type was not specified but compliance with workplace safety, transportation, and environmental standards was required.

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Classified and Unclassified Pouch and Mail Services – Offeror Information

OFFER INFORMATION

Offeror must complete form as applicable, please type information.

Legal Business Name of Entity Submitting Offer:

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Website:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Business Size in for NAICS 492110
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone |_| Veteran-Owned Service Disabled

Facility Clearance Level:

Joint Venture*:
|_| Yes or |_| No

Primary Offeror Point of Contact:

Phone Number Office & Cell:

Email Address:

*If Joint Venture, present a UEI number above for the Joint Venture. Then, complete below as applicable for each joint venture partner (complete multiple copies of this form if necessary to include all partners), and provide signed copy of JV Agreements:

Joint Venture Partner #1:

Legal Business Name:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Small Business in for NAICS 492110:
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Facility Clearance Level:

Website:

Point of Contact:

Phone Number:

Email Address:

Joint Venture Partner #2:

Legal Business Name:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Small Business in for NAICS 492110:
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Facility Clearance Level:

Website:

Point of Contact:

Phone Number:

Email Address:

Subcontractor #1:

Legal Business Name:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Small Business in for NAICS 492110:
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Facility Clearance Level:

Website:

Point of Contact:

Phone Number:

Email Address:

Subcontractor #2:

Legal Business Name:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Small Business in for NAICS 492110:
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Facility Clearance Level:

Website:

Point of Contact:

Phone Number:

Email Address:

Subcontractor #3:

Legal Business Name:

UEI Number:

Registered in SAM:
|_| Yes or |_| No
Small Business in for NAICS 492110:
|_| Small Business or |_| Other than Small

Socio-Economic Categories:

(check applicable) |_| Small Disadvantaged 8(a) |_| Other Small Disadvantaged |_| Small Women-Owned |_| HUBZone

Mailing Address: (Street Address)

(City, State, Zip Code)

(Country)

Facility Clearance Level:

Website:

Point of Contact:

Phone Number:

Email Address:

Joint Venture Signature Page Solicitation Number 19AQMM23R0015

Joint Venture Name and Address:

Joint Venture Participants:

Company A (Co A), by

_____________________________________________ Date: _________________ Signature Name:

Title:

Company B (Co B), by

_____________________________________________ Date: _________________ Signature Name:

Title:

Company C (Co C), by

_____________________________________________ Date: _________________ Signature Name:

Title:

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