Market_Survey_(blank)_.doc

MARKET SURVEY

January 13, 2016

RETURN FAX TO 614-692-7389

PHONE NUMBER 614-693-1613

Christy.Boyer@dla.mil I am preparing to issue a Request For Proposal (RFP) for the following part. Your answers to the following questions will help me develop the solicitation. Please respond to this Market Survey by close of business January 18, 2016.

COMPANY NAME:

CAGE:

ADDRESS:

CITY:

STATE:

ZIP CODE:

ATTN:

PHONE:

FAX:

DESCRIPTION

PR: 61842043

NSN: 5998-01-229-5893

Item: Electronic Component Quantity: 15 each (Price breaks up to 20 each).

Delivery: Please Provide Delivery Location:

Ship to address: Warner Robins, GA Parcel-Post Address:

F.O.B: Origin I/A: Destination

APPROVED SOURCES:

Boeing Company (82918) P/N 377-10807-502 MPC Products Corporation (19710) P/N E47T92F

PLEASE SELECT:

Dealer / Manufacturer Approved QPL Source

Qualified Supplier List of Distributors (QSLD)

Qualified Testing Supplier List (QTSL)

Authorized Distributor: Source of Supply: CAGE:

Dealer: Source of Supply: CAGE:

Business Size:

Large

Small

Do you deal through Dealers/Distributors or do you prefer dealing directly with the Government?

Are these commercial items? Yes / No

Are these catalog/price listed items? Yes / No

Are these items in your inventory? Yes / No

Are you willing to quote on these items? Yes / No If not, please state why:

What would you consider economical production quantities? Yes / No If yes, what would be the most appropriate incremental quantity breaks?

Quantity

Would you be willing to accept a priced quantity option? Yes / No Is your company registered with the System for Award Management (SAM)? Yes / No