Sources_Sought_Fillable_Form.pdf

USACE Detroit District Sources Sought Information Request Form - Page 1 of 2

Project Name:

Bonding requirement:

NAICS Code: ________________

Interested firms please respond with this information form and the following requested information. Please complete all sections of the document.

1. Company Information:

Company name: _________________________________________________________

Company Address as registered in SAM:

I have confirmed that my address listed above is exactly the same as listed in SAM The above address is not the same in SAM, but registration is being corrected to the above listed address

DUNS Number: ________________________________

Socio-economic status for the listed NAICS code - please check all that apply:

Large business Small business Small disadvantaged business 8(a) program participant Service-Disabled Veteran-Owned Small Business (SDVOSB) HUB Zone business Woman-Owned business

The firm must be registered in SAM (www.SAM.gov) with the socio-economic status identified above and the NAICS code specified in the sources sought notice. If the firm’s SAM record does not include this project’s NAICS code, the firm will not be considered.

I have confirmed that my firm is registered in SAM for the NAICS code and business type selected My firm is not registered in SAM with the NAICS code and business status selected, but the firm qualifies and registration is in process My firm is not registered in SAM for the identified NAICS code

2. Bonding Capability:

Individual Project Bonding: _____________________

Total Aggregate Bonding Capability: _____________________

This response must include a letter from your bonding company confirming this amount.

Bonding letter and/or certificate from bonding provider for amount listed above is attached with my response

My firm does not have a bonding capacity letter My firm cannot bond to the stated bond requirement

USACE Detroit District Sources Sought Information Request Form - Page 2 of 2

3. Examples of similar work:

I have attached three references for similar work that our firm has performed.

I have not attached three references of similar work that our firm has performed.

Please check one of the following boxes:

I understand that incomplete answers in sections or my failure to provide required documentation may remove my firm from consideration for this project sources sought notice.

I do not understand that incomplete answers on this form or my failure to provide documentation may remove my firm from consideration for the project sources sought and will contact the US Army Corps of Engineers Detroit District Contracting Office for help.

Name: ________________________________________________

Title: ________________________________________________

Phone Number: _______________________