Sources_Sought_Information_Request_Form.docx

Sources Sought Information Request Form

Project Name: Reprogramming of Existing Crestron System NAICS Code: 334310 Small Business Size Standard: 750 Employees NAICS Code 541511 Small Business Size Standard: $27.5 million the last three years

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:

CAGE CODE:

DUNS Number:

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

( ) Service-Disabled Veteran-Owned Small Business (SDVOSB)

By responding to the Sources Sought Notice, I confirm that my firm is registered in the System for Award Management (SAM) https://www.sam.gov with the socio-economic status identified above and the NAICS code specified in the sources sought notice; or that my firm qualifies and registration under the applicable NAICS code is in process.

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 the Government’s determination of whether to solicit the referenced project on a set-aside basis in accordance with Part 19 of the Federal Acquisition Regulation.

Name: _________________________________

Title: __________________________________

Signature: ______________________________