Sources_Sought_Information_Request_Form.pdf

Sources Sought Information Request Form

NAICS Code Company Name Company Information Company Address as registered in System for Award Management (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 CAGE Code

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

Large Business Small Business

Small Disadvantaged Business 8(a) Program Participant

HUB Zone Business Woman Owned Business

Service Disabled Veteran Owned Small Business (SDVOSB)

The firm must be registered in System for Award Management (SAM).

https://www.sam.gov/portal/SAM/ 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.

https://www.sam.gov/portal/SAM/

Certification:

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

Printed Name Title Phone Number Signature