Sources_Sought_Information_Request_Form.pdf

Sources Sought Information Request Form: W912L619B5000

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 System for Award Management (SAM):

DUNS Number:

Cage Code:

Socio-Economic Status for the listed NAICS code (mark all that apply):

___Large Business ___ Small Business

___Small Disadvantage Business ___8(a) program participant

___ HUB Zone Business ___ Woman Owned Business

___ Service Disabled Veteran Owned Small Business (SDVOSM)

The firm must be registered in System for Award Management (SAM) https://www.sam.gov/protal/public/SAM/ with the socio-economic status identified above and the NAICS code specified in the sources sought notice. If the firms SAM record does not include this project’s NAICS code, the firm will not be considered.

___ Please confirm that firm is registered in SAM for the NAICS code and business type selected or that firm qualifies and registration is in process.

https://www.sam.gov/protal/public/SAM/

2. Bonding Capability:

Individual Project Bonding:

Total Aggregate Bonding Capability:

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

___ 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.

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.

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 consideration for this project sources sought notice.

Signature:

Name:

Title:

Phone Number: