Sources_Sought_-_A-E_Information_Form.docx

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A-E Services for MS National Guard
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W9127Q19R0009
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SOURCES SOUGHT – A-E INFORMATION FORM

for Single Award Task Order Contract Mississippi National Guard

Use this form to provide A-E firm’s general information. Please limit response to one page. The box at the bottom of this form may be used to clarify any requested information. Upload to FedBizOps

1. Contractor Information:
DUNS* :

CAGE Code* :

Firm Name:

Address:

Name of POC for firm:

Phone Number of POC:

Email of POC:

2. Type of Business: (check all that apply)

|_| Small Business

|_| SBA certified HUBZone Small Business

|_| Service-Disabled Veteran-Owned Small Business

|_| Small Disadvantaged Business

|_| SBA certified 8(a) firm

|_| Women-Owned Small Business

3. Is your company currently registered in System for Award Management (SAM)? Yes |_| No |_|

4. Clarifications/Comments:

*DUNS & Cage Code are not required for this submission, however will be required for proposal submission

(Rev. 11/15)

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