Sources_Sought_Questionnaire.pdf

INDUSTRIAL AND MEDICAL GASES, COMPRESSED AND LIQUEFIED

CAPABILITY QUESTIONNAIRE

W9114F19Q0006

Please respond to all questions as completely as possible.

SECTION 1. GENERAL

1. Business Name:

2. Business Address:

3. Cage Code:

4. North American Industry Classification System (NAICS) code:

325120 – Industrial Gas Manufacturing

NOTE: If you feel the above NAICS Code is not sufficient for this acquisition, please provide your recommended NAICS code with an explanation.

5. Responsible Point of Contact: (Insert name, address, phone number, and email address)

SECTION 2. CONTRACTOR ARRANGEMENT

1. Our firm will be quoting on this project as a:

Sole Contractor, Prime Contractor self-performing at least 15% of the work, Prime Contractor performing at least 15% of the work with the following team member subcontractor(s) (Insert business name, business size, cage code, and work which will be subcontracted), or

Joint Venture with (Insert business name, business size, and cage code). (See FAR subpart 9.6 for Government policy on teaming arrangements at https://www.acquisition.gov/content/subpart-96-contractor-team-arrangements)

SECTION 3. CAPABILITY QUESTIONNAIRE

1. Does your company have the ability to deliver to the following locations (Place an “X” for all locations you are able to deliver to)?

Locations in Germany such as:

Landstuhl Regional Medical Center, Wiesbaden Health Clinic, Wiesbaden Dental Clinic, https://www.acquisition.gov/content/subpart-96-contractor-team-arrangements

Baumholder Health Clinic, Baumholder Dental Clinic, Kaiserslautern Health Clinic, Kaiserslautern Dental Clinic, Pulaski Dental Clinic in Kaiserslautern Bavaria MEDDAC Vilseck, Vilseck Army Health Clinic, Vilseck Dental Clinic, Grafenwoehr Army Health Clinic, Grafenwoehr Dental Clinic, Hohenfels Army Health Clinic, Hohenfels Dental Clinic, Ansbach Army Health Clinic, Ansbach Dental Clinic, Katterbach Army Health Clinic, Katterbach Dental Clinic, Katterbach Veterinary Clinic Stuttgart Army Health Clinic, Stuttgart Dental Clinic Public Health Command-Europe (PHC-E) in Landstuhl U.S. Army Medical Materiel Center Europe (USAMMCE) in Pirmasens

Locations in Belgium such as:

SHAPE Healthcare Facility, NATO Brussels Health Clinic

2. Our firm is capable of performing the following delivery cycle:

weekly biweekly monthly Emergency Oxygen

Other

3. Does your company have the capability to deliver the gases listed in Attachment 1? (Place an “X” on all items that your company is capable to deliver)

4. Does your company have any professional conflict of interest that would prevent you from submitting a quote for this acquisition?

Yes No

SECTION 4. RETURN INSTRUCTIONS.

After you have completed all sections of the capability questionnaire, please return the form to the Contract Specialist via email at HenningFalk.Mayer-Goldstein.LN@mail.mil and Responses shall be received NO LATER THAN: Thursday, 06 June 2019 at 16:00 hours local German time. Information presented is for market research purposes only. A solicitation will be posted in the near future for the actual requirement. Quotes are not requested at this time.

mailto:HenningFalk.Mayer-Goldstein.LN@mail.mil

ATTACHMENT 1 – Estimated Items List

Type of Gases or Description

Quality (Purity) of Gases

Container Type Container Size

Container Pressure Capability

Argon 99.9980% Cylinder 50L 200BAR Argon 99.9980% Cylinder 5L 200BAR Carbon Dioxide 99.5000% Cylinder 40L Carbon Dioxide 99.9950% Cylinder 20L Carbon Dioxide 99.7000% Cylinder 10L Carbon Dioxide 99.7000% USP Cylinder, Type E 1-10L

Compressed Air Med.

Grade Cylinder 50L 200BAR

Compressed Air Med.

Grade Cylinder 3-10L 200BAR

Nitrogen 99.9500% Cylinder 40L 150BAR Nitrous Oxide, Med. 97.0000% Cylinder 40L 225BAR Nitrous Oxide, Med. 97.0000% Cylinder 10L 225BAR Nitrous Oxide 97.0000% Cylinder 3L Nitrous Oxide, Med. 97.0000% Cylinder 2L 250BAR Oxygen, Med. 99.5000% Cylinder 50L 200BAR Oxygen, Med. 99.0000% Cylinder 21-40L 150BAR Oxygen, Med. 99.0000% Cylinder 40L 150BAR Oxygen, Med. 99.0000% Cylinder 5-10L 150BAR Oxygen, Med. 99.0000% Cylinder 1-10L 150BAR Oxygen, Med. 99.0000% Cylinder 3L 200BAR Oxygen, Med. 99.0000% Cylinder 2L 150 BAR Propane 95.0000% Cylinder 33KG Propane 95.0000% Cylinder 11KG Propane 95.0000% Cylinder 5KG Cylinder Rental, daily Pallet Rental, monthly Cap Removal & Replacement Exterior Cleaning & Re-Painting Cylinders Preparation of Gov Owned Cylinders Interior Cleaning & Drying of Cylinder Metal Stamping of Cylinder Re-Testing (TUEV) of Empty Cylinder Removal of Paint from Cylinder Shoulder Valve Removal & Replacement Oxygen, Liquid, Med. 99.5000% Tank Rental, Bulk Liquid Oxygen

ATTACHMENT 1 – Estimated Items List

Type of Gases or Description

Quality (Purity) of Gases

Container Type Container Size

Container Pressure Capability

Argon, Liquid 99.9980% for Tank Tank Rental, Bulk Liquid Argon, monthly 5000L high pressure Nitrogen, Liquid 99.9960% for Tank Tank Rental, Bulk Liquid Nitrogen, monthly 5000L high pressure Argon 99.999% / Methane 99.95%, 90/10 mix Cylinder 50L 200BAR Carbon Dioxide 99.9950% Cylinder 50L 200BAR Helium 99.9999% Cylinder 50L 200BAR Helium, Bundle 99.9999% Bundle/Pallet of 12 50L 200BAR Hydrogen 99.9999% Cylinder 50L 200BAR Oxygen 99.9990% Cylinder 50L 200BAR Cylinder Rental (Asst Type & Capacity), monthly

Nitrogen 99.9990% Cylinder 50L 200BAR Nitrogen 99.9999% Cylinder 50L 200BAR Argon 99.9990% Cylinder 50L 200BAR Nitric Oxide, INOmax, 800ppm Cylinder 10L Calibration Gas, INOcal, NO/NO2/N2 Cylinder 10L INOvent System Rental Nitrogen, Liquid 99.9500% for Tank Tank Rental, Bulk Liquid Nitrogen Tank Nitrogen, Liquid 99.5000% for Dewar Nitrogen Delivery, SHAPE, Belgium Nitrogen Delivery, NATO, Belgium Carbon Dioxide 99.5000% Cylinder 50L Oxygen, Med. 99.0000% Cylinder 5L Cylinder Rental, monthly Cylinder Transport, SHAPE, Belgium Cylinder Transport, NATO, Belgium Dry Ice, Nuggets Container 110KG Dry Ice, Nuggets Container 300KG Dry Ice, Nuggets, 16mm Diameter Container on Wheels 110KG