Market_Survey_Blank.docx

DEFENSE LOGISTICS AGENCY

LAND AND MARITIME

P.O. BOX 3990

COLUMBUS, OHIO 43218-3990

MARKET SURVEY QUESTIONNAIRE

Please Respond

THIS IS NOT A REQUEST FOR QUOTE

INFORMATION REQUIRED FOR PENDING REQUEST FOR PROPOSALS

Date:

To:

Cage:

NOTE: ITEM LISTED IS BEING CONSIDERED FOR SOLICITATION AND SUBSEQUENT AWARD.

PLEASE RETURN SURVEY BY COB

DLA Land & Maritime (Columbus) is considering a solicitation and subsequent Award on a Contract for the items below.

As a potential supplier of these items, we are asking that you fill out this market survey to the best of your knowledge so that we can generate a realistic and beneficial solicitation.

NOTE: This Contract may result in a Quantity Option.

Please indicate the absolute best delivery (in Days) you would be able to provide this item.

REQUIREMENTS:

PLEASE COMPLETE THE FOLLOWING:

The NAICS code for this item is: 336390 Please indicate below your business size for this NAICS code.

Please ensure that your SAM information and ORCA certifications reflect this NAICS code.

SAM website: https://www.sam.gov ORCA website: https://orca.bpn.gov/login.aspx

|_| Large Business / |_| Small Business

|_| Manufacturer / |_| Dealer

Are you the ACTUAL Manufacturer of the item? |_| Yes |_| No

Identify Source of Supply if Dealer: ___________________________________________________

1. Do you deal through dealer/distributors or do you prefer to deal directly with the Gov’t? |_| Dealer |_| Gov’t

2. Do you carry this item in your inventory? |_| Yes |_| No

3. Is this item quantity sensitive? |_| Yes |_| No

4. Is this a commercial item? |_| Yes |_| No

5. Are these commercial off the shelf items with commercial sales history? |_| Yes |_| No

6. Are these catalog/price listed items? |_| Yes |_| No

7. Are you able to supply us with a copy of your price list? |_| Yes |_| No

8. If “NO” to #4; are these items modified items of a type available in the commercial market place? |_| Yes |_| No

9. If “NO” to #8; do these items have minor modifications of a type not customarily available in the commercial

10. If “NO” to #4 & if these are not currently in the commercial market place; will these items be available in the commercial market place in time to satisfy the gov’t delivery requirements on this project? |_| Yes |_| No

11. Does this item contain hazardous material? |_| Yes |_| No

12. Can you provide STD-COM Pkg I/A/W ASTM D 3951 and provide/comply with RFID? |_| Yes |_| No

13. If "NO" to #12, are you currently in the process of obtaining the facilities to comply with RFID? |_| Yes |_| No

14. What is your approximate delivery for this item: ________________________________________

15. The Government prefers to utilize F.O.B. Origin; is this acceptable? |_| Yes |_| No

16. Do you offer quantity/price breaks for this item and if so, please provide below:

COMMENTS: _________________________________________________________________________________

Name/Signature: _______________________________________________

Phone Number: ________________________________________________

We Sincerely Appreciate Your Time, And Thank You For Providing This Information.

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