Vendor Request Form.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 36C25621R0112
About this file
This document outlines a solicitation for replacing the roof and HVAC system for Building 3 at the Alexandria VA Health Care System. The solicitation will be issued as a 100% set-aside for Service-Disabled Veteran Owned Small Businesses. Interested offerors must be registered and verified as an SDVOSB in the Vendor Information Pages database and System for Award Management by the time of proposal submission. The construction cost range for the project is between $5 million and $10 million. The prime contractor must perform at least 15% of on-site work costs using its own employees or employees of other eligible SDVOSBs. The applicable NAICS code is 236220. The solicitation will be posted on Beta.SAM.gov on or after June 15, 2021, where the request for proposal and any amendments can also be downloaded at no cost.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25621R0112 0001.docx | DOCX document | |
| BLDG 3 Site Visit Information.pdf | ||
| WDLA202110051 04302021.txt | TXT text file | |
| 36C25621R0112.docx | DOCX document | |
| EXHIBIT F REQUEST FOR INFORMATION FORM.docx | DOCX document | |
| Vol 2-Specs.pdf | ||
| ACM and LeadReports.pdf | ||
| Drawings volume 2.pdf | ||
| Drawings Volume 1.pdf | ||
| EXHIBIT D CONTRACTOR EVALUATION FORM CONSTRUCTION SAFETY.docx | DOCX document | |
| EXHIBIT B PAST AND PRESENT PERFORMANCE QUESTIONNAIRE.docx | DOCX document | |
| EXHIBIT E SURETY FORM.docx | DOCX document | |
| J_A 502-19-102 (BC Signed) v1_Redacted.pdf | ||
| EXHIBIT A PERFORMANCE RELEVANCY SURVEY.docx | DOCX document | |
| EXHIBIT G RETURNABLES.docx | DOCX document | |
| Vol 1-Specs v2.pdf | ||
| Project Risk Assessment Replace Roof and HVAC building 3.pdf | ||
| EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT.docx | DOCX document | |
| VA10091 FMS Vendor Request Form EFT.pdf | ||
| SOW-04052021.docx | DOCX document |
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Text version
Sheet1
| * | VENDOR NAME: | |
| * | ORDERING ADDRESS 1: | |
| * | ORDERING ADDRESS 2: | |
| * | ORDERING CITY: | |
| * | ORDERING STATE: (SPELL OUT) | * ORDERING ZIP CODE: |
| * | VENDOR FAX NUMBER: | |
| * | TAX ID/SSN #: (9 digits) |
| * | SNN/TAX ID: (Check One) | S = Social Security No. | T = Tax Identification No. | |
| * | PAYMENT ADDRESS 1: | |||
| * | PAYMENT ADDRESS 2: | |||
| * | PAYMENT CITY: | |||
| * | PAYMENT STATE: | * PAYMENT ZIP CODE: | ||
| 1099 VENDOR INDICATOR: |
| * | VENDOR TYPE: (Check One) | A = Agent Cashier | O = Other Countries |
| C = Commercial | R = Commercial-Recurring Pmts | ||
| E = Employee | U = Utility Companies | ||
| F = Federal Government | V = Veterans | ||
| G = GSA | K = Canteen | ||
| I = Individual Others | |||
| * | PHONE NUMBER: | ||
| CONTACT PERSON: | |||
| ACCOUNT NUMBER: | |||
| CONTRACT NUMBER: | |||
| BEGINNING DATE: | |||
| EXPIRATION DATE: | |||
| CONTRACT TERMS: | |||
| CONTRACT/BOA # CONTRACT FLAG: |
| * | BUSINESS TYPE (FPDS): (Check One) | 1 = Small | 3 = Outside U.S. |
| 2 = Large | 4 = Other Entities |
| * | SOCIOECONOMIC GROUP: | N = Small Disadvantaged Business |
| (Check as Necessary) | P = Javits-Wagner-O'day (JWOD) | |
| W = Woman-Owned Small Business | ||
| OO = None of the Other Categories | ||
| S = Veteran-Owned Small Business | ||
| LW = Woman-Owned Large Business | ||
| LV = Veteran Owned Large Business | ||
| U = Historically Black Coll & Univ/Min Inst HBCU/MI | ||
| RV = Service-Disabled Veteran | ||
| HZ = Hubzone Small Business Concern | ||
| SPECIAL FACTORS: | ||
| GUARANTEED DELIVERY: | ||
| SELECT SYNONYM: | ||
| IS A SF129 ON FILE: | ||
| * | DUNN & BRADSTREET #: (9 digits) |
| ACCEPT CREDIT CARD: (Check One) | YES | NO | ||
| CCR EXP. DATE | ||||
| * | SUBMITTED BY: | DATE SUBMITTED: | ||
| * ASTERISKS INDICATE REQUIRED INFORMATION AND MUST BE COMPLETED |
Sheet2
File details come from the government source that posted it. Updated .