SOURCES SOUGHT_CONTRACTOR FORM 02.docx
DOCX document 18 KB Posted
- Solicitation number
- 36C25526Q0471
About this file
This is a Sources Sought Contractor Information Form template designed for the Network Contracting Office 15 to collect general information from potential contractors interested in federal contracting opportunities.
The form requests basic contractor identification details including business name, address, SAM UEI, and point of contact information (name, phone, email). It requires contractors to identify their business classification by selecting applicable categories such as SBA certifications (8(a) firms, HUBZone small businesses, service-disabled veteran-owned small businesses, women-owned small businesses, economically disadvantaged women-owned small businesses, veteran-owned small businesses), large business status, or other designations. The form also requests contractors to document their project experience by identifying the number of projects completed within specified budget ranges, with a reference to projects valued at $5 million and above. Additionally, the form includes a section for contractors to provide a capabilities statement. The form explicitly limits responses to one page and provides a clarification box at the bottom for additional context. This is a template document used during the pre-solicitation phase to identify potential sources for contracting opportunities, in this case related to weapons storage (arms room/safe) requirements for the VA Police Department at the Rolla Community Based Outpatient Clinic under the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25526Q0471_Sources Sought.docx | DOCX document | |
| SOURCES SOUGHT_CONTRACTOR FORM_Fillable.pdf |
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Text version
SOURCES SOUGHT – CONTRACTOR INFORMATION FORM
for
NETWORK CONTRACTING OFFICE 15
Use this form to provide contractor’s general information. Please limit response to one page. The box at the bottom of this form may be used to clarify any requested information.
1. Contractor Information:
| Business Name: |
| Address: |
| SAM UEI: |
| Name of POC for Business: |
| Phone Number of POC: |
| Email of POC: |
2. Type of Business: (check all that apply)
| |_| SBA certified 8(a) firm |
| |_| SBA certified HUBZone Small Business |
| |_| Service-Disabled Veteran-Owned Small Business |
| |_| Veteran-Owned Small Business |
| |_| Economically Disadvantaged Women-Owned Small Business |
| |_| Women-Owned Small Business |
| |_| Other: ___________________________ |
| |_| Large Business |
| 3. Please identify number of projects your organization has performed at the different ranges identified below: | ||
| <$500K | ______ $500K ~ $1M | ______ |
| $1M ~ $2M | ______ $2M ~ $5M | ______ |
| >$5m | ______ |
4. CAPABILITIES STATEMENT:
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