Market_Survey_(blank)_67272676_.doc

MARKET SURVEY

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 February 15, 2017.

COMPANY NAME:

CAGE:

ADDRESS:

CITY:

STATE:

ZIP CODE:

ATTN:

PHONE:

FAX:

DESCRIPTION

PR: 67272676

NSN: 5962-01-482-1678

Item: Microcircuit, Hybrid Quantity: 350 each with price breaks up to 450 each. (Please confirm 350 is your minimum order quantity) Delivery: Please provide

Ship to address: Columbus, Ohio F.O.B: Origin (FDT applies)

I/A: Destination

APPROVED SOURCES:

PLEASE SELECT: HONEYWELL (07187) P/N 1903174-901

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

What is the estimated price for this item? $________________________

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 Will you supply Certified Cost / Price Data if your offer breeches TINA ($750K)? Yes / No