Market_Survey_blank_.doc

MARKET SURVEY

November 17, 2014

PHONE NUMBER 614-692-8565

Amy.Plymale-Hillis@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 November 24, 2014.

COMPANY NAME:

CAGE:

ADDRESS:

CITY:

STATE:

ZIP CODE:

ATTN:

PHONE:

FAX:

DESCRIPTION

PR: 0055631396

NSN: 5998-01-545-2665

Item: Circuit Card Assembly Quantity: 25 Delivery: Please Provide Delivery Location: DLA stock Depot: W25G1U, W1BG DLA DISTRIBUTION, DDSP NEW CUMBERLAND FACILITY

Ship to address:

2001 NORMANDY DRIVE DOOR 113 TO 134

NEW CUMBERLAND PA 17070-500

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

APPROVED SOURCES:

PLEASE SELECT:

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:

If this item is assigned in the Federal Stock Class (FSC) 5962, do you DNA mark? Yes / No

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 What is the approximate delivery for this quantity?

What would be the most appropriate incremental quantity breaks?

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