Market_Survey.doc

DLA LAND AND MARITIME - MARKET RESEARCH

Company Name:

CAGE:

Your Name:

Phone Number:

E-Mail address:

Date:

REQUIREMENTS:

PLEASE COMPLETE THE FOLLOWING:

Do you intend to quote on this NSN? FORMCHECKBOX

YES FORMCHECKBOX

NO If not, why?______________

FORMCHECKBOX

LARGE OR FORMCHECKBOX

SMALL BUSINESS

FORMCHECKBOX

MANUFACTURER OR FORMCHECKBOX

DEALER

Can you meet the government’s delivery?

FORMCHECKBOX

YES FORMCHECKBOX

NO If not, what is your delivery? __________

Do You Carry This Item In Your Inventory?

FORMCHECKBOX

YES FORMCHECKBOX

NO

Are any of these items Commercial Items per FAR 2.101(b)? NO

YES

If YES to question above, above can you provide commercial sales invoices, listing in catalogs or brochures, known established price list to commercial market place, availability or announcement to the general public?

FORMCHECKBOX

YES FORMCHECKBOX

NO

Does This Item Contain Hazardous Material?

Is FOB Origin Acceptable?

NO

If required is Inspection/Acceptance at Origin Acceptable?

FORMCHECKBOX

YES FORMCHECKBOX

Is There a Minimum Order Quantity?

NO

-If “Yes” Please Provide Minimum Quantity ___________________________

Please Provide Any Recommended Economical QTY Price Breaks:

Can Your Firm Provide Cost & Price Data if Required?

The Government last paid $2124.00 EA for this item. Is it reasonable to expect a unit price near this for the current requested quantity? This is for planning only, and is not a binding quote.

NO

COMMENTS/FEEDBACK:

APPROVED SOURCES:

ORAN SAFETY GLASS, INC. DBA ORAN 4M0Z0 P/N 79-102-C400000

ORAN SAFETY GLASS, INC. DBA ORAN 4M0Z0 P/N 79-102-C94000

SCHOTT GOVERNMENT SERVICES, LLC 508C3 P/N PN003266

OSHKOSH DEFENSE, LLC DBA 75Q65 P/N 4038168

IAW REFERENCE DRAWING NR 19200 ATPD-2352, REVISION NR T DTD 05/08/2013, PART PIECE NUMBER:

IAW REFERENCE DRAWING NR 19207 14003552, REVISION NR DTD 05/01/2013, PART PIECE NUMBER:

IAW REFERENCE QAP 16236 SQAP016001911, REVISION NR DTD 04/17/2015, PART PIECE NUMBER:

IAW REFERENCE QAP 4M0Z0 CDRL-016001911-PLT, REVISION NR DTD 04/17/2015, PART PIECE NUMBER:

IAW REFERENCE QAP 16236 SQAP016001911, REVISION NR DTD 04/16/2015, PART PIECE NUMBER:

For Official Use Only

Please understand and comply with all regulations concerning Source Selection Information per FAR 2.101 and 3.104