Sources Sought Info Req Form-Case Management FY26 NYARNG.docx
DOCX document 32 KB Posted
- Solicitation number
- W912PQ26QA003
About this file
This is a Sources Sought Information Request Form for Medical and Dental Case Management Services for the New York Army National Guard (NYARNG). The opportunity seeks qualified vendors in specific Small Business Administration (SBA) certified categories, including 8(a), HUB Zone, Service-Disabled Veteran-Owned Small Business (SDVOSB), Women-Owned Small Business (WOSB), and Economically Disadvantaged Women-Owned Small Business (EDWOSB), with NAICS code 541611 and a size standard of $21.5 million.
The contract requires contractors to provide non-clinical administrative support to the State Surgeon, Deputy State Surgeon, and Medical Standards Officer, aiding in medical decision-making processes and providing administrative advice to unit Commanders. Interested firms must be registered in SAM, complete the sources sought information form, submit a five-page capabilities statement, provide a list of previous contracts from the past three years, and outline resources, subcontractors, and key personnel licensed to perform services in New York State. Respondents should email the completed form to Richard.w.powell44.civ@army.mil and Melissa.santoro2.civ@army.mil.
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| File | Type | Posted |
|---|---|---|
| PERFORMANCE WORK STATEMENT (REV.1DEC25) (DRAFT).docx | DOCX document |
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Sources Sought Information Request Form
Project Name: Medical and Dental Case Management Services at for the New York Army National Guard, 1 Buffington St. BLDG 25 Suite 336 Watervliet, NY 12189
Bonding requirement: No NAICS Code: 541611
Interested firms please respond with this information form and the following requested information. Please complete all sections of the document.
1. Company Information:
Company name:
Company Address as registered in SAM at https://www.sam.gov/SAM/ :
( ) I have confirmed that my address listed above is exactly the same as listed in SAM ( ) The above address is not the same in SAM, but registration is being corrected to the above listed address
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)
The firm must be registered in SAM (https://www.sam.gov/SAM/ ) with the socio-economic status identified above and the NAICS code specified in the sources sought notice. If the firm’s SAM record does not include this project’s NAICS code, the firm will not be considered.
( ) I have confirmed that my firm is registered in SAM for the NAICS code and business type selected ( ) My firm is not registered in SAM with the NAICS code and business status selected, but the firm qualifies and registration is in process ( ) My firm is not registered in SAM for the identified NAICS code
Statement of interest/capabilities statement shall not exceed five typewritten pages statement of intent to offer a quote with capabilities.
A completed and signed Sources Sought Information Request Form (this form) A listing of previous contracts withing the past three years, both for government and private industry. The type of services provided, the dollar value, contract number, location, and point of contact are to be included.
A brief outline of resources, subcontractors, and key personnel licensed to perform these services in NYS and the type of license they possess that would be used to accomplish the contract.
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 consideration for this project sources sought notice.
| Signature: | Name: |
| Title: | Phone Number: |
Email completed form to Richard.w.powell44.civ@army.mil and Melissa.santoro2.civ@army.mil
File details come from the government source that posted it. Updated .