Supplier Management Intake Form V14.pdf

INTERNAL REVENUE SERVICE

PROCUREMENT SUPPLIER MANAGEMENT INTAKE FORM

The IRS is requesting information from industry to gather market research to build supplier profiles based on capabilities. The IRS has the responsibility of fulfilling agency goals related to procurement that require gathering information on the current state of industry, for both large and small businesses. This information will increase IRS understanding of the supplier base and encourage higher quality and targeted engagement with suppliers. The IRS is interested in knowing what capabilities of industry can support the overall IRS mission.

Part I

1. Business Name 2. Doing Business As (DBA)

3. Business Website Address

4. Business Street Address 5. City 6. State 7. County 8. Zip+4 Code

9. Date of Incorporation/Inception 10. Point of Contact 11. Point of Contact Title

12. Point of Contact E-mail Address 13. Phone Number

14. Alternate Point of Contact 15. Alternate Point of Contact Title 16. Phone Number

17. Alternate Point of Contact E-mail Address

Part II

Commercial and Government Entity (CAGE) Code: This code is assigned through System for Award Management (SAM). If you have not registered, it is suggested that you consider visiting http://www.sam.gov to register prior to completing this form.

1. Is your company registered on sam.gov?

2. CAGE Code: 3. Unique Entity Identifier (UEI):

4. North American Industry Classification System (NAICS Code(s)) Maximum of 5:

A. B. C. D. E.

5. Does your company provide products or services in any of the following categories? Please select all that apply with “X”.

Information Technology

Program Management Services

Facilities & Construction

Financial Management

Transportation & Logistics Services

Security & Protection

Human Capital

Medical

Industrial Products & Service

Travel & Lodging

Other http://www.sam.gov/ https://www.naics.com/search/

6. Please check all the categories that best describe your company. (Please access the Small Business Administration site for Size Standards) Size:

Large Business?

Small Business?

If a Small Business, please select all socio-economic programs and small business programs that apply with “X”.

*8(a) Business Development Certified Small Disadvantaged/Minority HBCU/Minority Institution

Other Educational Institution *Historically Underutilized Business Zone (HUBZone) Alaska Native Corporation (ANC) Native American/Native Hawaiian Organization (NHO) Community Development Corporations (CDC) **Service-Disabled Veteran Owned Small Business

**Veteran Owned Small Business Women Owned Small Business Other *Certified by the Small Business Administration **Verified by the Veterans Administration

7. Do you offer your product(s) or service(s) currently on GSA’s Federal Supply (FSS) program?

If so, please specify which Multiple Award Schedule (MAS) categories and Special Item Numbers (SINS).

8. Please check all the contract vehicles available to your company with “X”.

GSA Federal Schedule

NASA SEWP

Other Federal GWAC

AbilityOne

NIH

Other (Please list additional contract vehicles)

9. Have you ever conducted business with the IRS?

9(a). If you have, please provide feedback on your experience with IRS procurement.

9(b). If you have not, please share the reasons for not doing so.

10. Have you attended an industry event at the IRS within the past twelve (12) months?

If yes, please identify the Business Unit that you engaged with or name of events that you attended:

11. Would you like to become a member of an e-mailing list for future IRS Procurement events or announcements?

If so, please provide the inbox where e-mails should be sent:

12. Are you actively utilizing the Treasury Dynamic Forecast (acquisition forecast) to locate planned/potential IRS contracts published on https://sbecs.treas.gov/Forecast.aspx?

13. Please attach a brief capability statement, not to exceed 2 pages.

NOTE: This correspondence or process does not promise, commit, or imply that a contract will be awarded.

A. C. D. E.B.

https://www.sba.gov/federal-contracting/contracting-guide/size-standards https://www.gsa.gov/buying-selling/purchasing-programs/gsa-multiple-award-schedule https://sbecs.treas.gov/Forecast.aspx