Market_Survey_Blank.doc

MARKET SURVEY

January 13,2016

MARKET SURVEY

FEBRUARY 4, 2016

RETURN FAX TO 614-692-8565

PHONE NUMBER 614-693-1612

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 February 11, 2016.

COMPANY NAME:

CAGE:

ADDRESS:

CITY:

STATE:

ZIP CODE:

ATTN:

PHONE:

DESCRIPTION

PR: 0061882553

NSN: 5915-01-242-6793

Source(s): Crane Electronics, CAGE 27338, P/N 520-16D Raytheon, CAGE 3B150, P/N 848479-1 Raytheon, CAGE 54X10, P/N 848479-1

Cobham, CAGE 1BWN1, P/N WJ-5276-1

Communications & Power, CAGE 99313, P/N 848479

Item: Filter, Band Pass Quantity: 5 F.O.B: Origin Inspection/Acceptance: Destination Delivery: Please Provide Delivery Location/Ship to address:

Freight Forwarder (Customer Direct- OCONUS) Is your company interested in pursuing a Firm Fixed Price Contract for the above item? [ ] yes [ ] no

Your company size: [ ] large or [ ] *small business

*What type of a small business?

Your company is a:

[ ] manufacturer [ ] *dealer or [ ] *distributor (*Identify source of supply __________________________)

[ ] Qualified Supplier List of Distributors (QSLD)

[ ] Qualified Testing Supplier List (QTSL)

Do you carry this item in your inventory? [ ] yes [ ] no

Is this a “commercial” item per FAR 2.101(b)? [ ] *yes [ ] no

NOTE: *Please complete the following if “yes”.

a) ______% sold to the general public / private sector.

b) ______% sold to the Government Are there a current Price List / catalog available and accessible to the general public? [ ] *yes [ ] no

Does your company deal through Dealers/Distributors or does your company prefer dealing directly with the Government?

Are these items in your inventory? [ ] yes [ ] no Would you be willing to submit an offer on this item? [ ] yes [ ] *no

*If no, why?

What would you consider economic production quantities? Yes / No

Does this item have a minimum order quantity? [ ]*yes [ ] no

*If yes, what is the quantity

What would be the most appropriate incremental quantity breaks?

Would you be willing to accept a priced quantity option? Yes / No

What is the approximate delivery for this quantity?

Is Inspection / Acceptance at Origin acceptable? [ ] yes [ ] no

Is Inspection / Acceptance at Destination acceptable? [ ] yes [ ] no

Is your company registered with the System for Award Management (SAM)?

[ ] yes [ ] no