Market_Survey_-_Blank.doc

“DLA LAND & MARITIME - MARKET RESEARCH”

This is “Not” a Request For Quote.

Information required for pending RFP.

DATE: April 29, 2016

CAGE:

ATTN:

ADDRESS:

PHONE:

FAX:

EMAIL

(*ADDRESS, PHONE, & FAX CORRECTION/UPDATE REQUESTED)

FROM: Juliana Secrist, DLA Land & Maritime-FMD

Reference:

DEFENSE SUPPLY CENTER, COLUMBUS

PHONE: (614)692-1068

FAX: (614)693-1572

NOTE: Item listed is being considered for solicitation and subsequent award. Please FAX or Email Survey NLT May 9, 2016 If further assistance is required, please call (Juliana Secrist) @ (614) 692-1068 Or e-mail: (juliana.secrist@dla.mil )

REQUIREMENTS:

PLEASE COMPLETE “ALL” OF THE FOLLOWING IN REGARDS TO THE “ABOVE” REQUIREMENTS:

1. YOUR COMPANY SIZE: FORMCHECKBOX

LARGE OR FORMCHECKBOX

*SMALL BUSINESS

*If Small Business, list number of employees:

2. YOUR COMPANY IS A: FORMCHECKBOX

MANUFACTURER OR FORMCHECKBOX

*DEALER OR FORMCHECKBOX

*DISTRIBUTOR

*IDENTIFY SOURCE OF SUPPLY IF DEALER/DISTRIBUTOR: ___________________________________

3. IS THIS A COMMERCIAL ITEM? FORMCHECKBOX

*YES FORMCHECKBOX

NO

Note: Must complete the following if Yes.

*IF “YES”: ______% SOLD TO PRIVATE SECTOR AND ______% SOLD TO GOVERNMENT

*IF ITEM IS COMMERCIAL, WILL YOU COMPLY WITH THE SOLICITATION CLAUSES/REQUIREMENTS

SPECIFIED IN:

FAR Part 12-Acquisition of Commercial Items? FORMCHECKBOX

YES FORMCHECKBOX

FAR Part 15-Contracting Negotiation (Non-Commercial clauses)? FORMCHECKBOX

YES FORMCHECKBOX

NO

4. IS THIS A CATALOG/PRICE LISTED ITEM? FORMCHECKBOX

YES FORMCHECKBOX

NO

5. IS THIS ITEM ON A GSA SCHEDULE? FORMCHECKBOX

*YES FORMCHECKBOX

NO

*IF “YES”, PLEASE SUPPLY A COPY OF THE SCHEDULE.

6. DO YOU CARRY THIS ITEM IN YOUR INVENTORY? FORMCHECKBOX

YES FORMCHECKBOX

NO

“DLA LAND & MARITIME - MARKET RESEARCH”

ATTN: DLA LAND & MARITIME-FMD

(Ref: 4720-00-555-3826-Continued)

7. COST/PRICING DATA QUESTIONS:

For contracts estimated over $750K, cost or pricing data may be required. Note: The value of the contract is based on the Contract Maximum dollar value. This Contract Maximum is based on the estimated value of the highest quantity of the highest price break range. Note for dealers/distributors: If cost or pricing data were required for the contract, the manufacturer is the subcontractor and would also be required to submit cost or price data if your purchase price from the manufacturer exceeds the $750K as stated above.

**is your company able to provide this data if required FORMCHECKBOX

YES FORMCHECKBOX

NO

IF NOT, WHY? _____________________________________________

**is your subcontractor(s) able to provide this data if required FORMCHECKBOX

YES FORMCHECKBOX

NO

8. WOULD YOU BE WILLING TO SUBMIT AN OFFER ON THIS ITEM? FORMCHECKBOX

YES FORMCHECKBOX

*NO

*IF NOT, WHY? ___________________________________________________________________

9. WHAT IS THE APPROXIMATE DELIVERY SCHEDULE FOR THIS ITEM?

START-UP TIME: _________________ START-UP QTY: _________________

MONTHLY PRODUCTION QTY: _________________

*10. WHAT ARE THE MOST APPROPRIATE INCREMENTAL QUANTITY BREAKS FOR THIS ITEM?

11. WOULD YOU BE INTERESTED IN DIRECT VENDOR DELIVERY (DVD)? FORMCHECKBOX

YES FORMCHECKBOX

NO

12. DO YOU HAVE ELECTRONIC DATA INTERCHANGE (EDI) CAPABILITY? FORMCHECKBOX

YES FORMCHECKBOX

*NO

*IF NOT, ARE YOU WILLING TO OBTAIN THIS CAPABILITY? FORMCHECKBOX

YES FORMCHECKBOX

NO

13. IS FOB ORIGIN ACCEPTABLE? FORMCHECKBOX

YES FORMCHECKBOX

NO

IS FOB DESTINATION ACCEPTABLE? FORMCHECKBOX

YES FORMCHECKBOX

NO

14. IS INSPECTION/ACCEPTANCE AT ORIGIN ACCEPTABLE? FORMCHECKBOX

YES FORMCHECKBOX

NO

IS INSPECTION/ACCEPTANCE AT DESTINATION ACCEPTABLE? FORMCHECKBOX

YES FORMCHECKBOX

15. Comments:

COMPLETED BY: ___________________________________________ DATE: _________________

(Please Print Name)

ADDITIONAL INFORMATION

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