Attachment B - Vendor Feedback Form

Attachment B - Vendor Feedback Form

Vendor/Company Information

Vendor/Company Name: Click or tap here to enter text.
Vendor/Company SAM UEI Number: Click or tap here to enter text. SAM Registration Expiration Date: Click or tap here to enter text.Vendor/Company GSA Contract Number: Click or tap here to enter text.GSA Contract Performance End Date: Click or tap here to enter text. Socioeconomic Status under Cited GS Contract Number(check all that apply): ☐Small Business
☐Economically Disadvantaged Women Owned Small Business (EDWOSB) ☐SBA Certified 8(a) Firm
☐SBA Certified HUBZone Firm
☐SBA Certified Small Disadvantaged Business
☐Service Disabled Veteran Owned Small Business
☐Veteran Owned Small Business
☐Women Owned Business
☐Women Owned Small Business (WOSB)
☐Other Than Small Business

Is your company a member of a small business joint venture that is capable of providing all the requested services found within the Draft Statement of Work (SOW)? If NO is selected, which service(s) is/are your company not able to provide? See https://legacy.sba.gov/federal-contracting/contracting-assistance-programs/joint-ventures for more information.

☐ YES☐ NO

Is your company capable of providing all the requested services found within the Draft Statement of Work (SOW) under your existing GSA schedule contract? If NO is selected, which service(s) is/are your company not able to provide?

☐ YES☐ NO

Click or tap here to enter text.

Does your company provide the services under an existing contract vehicle, that the FDA may utilize the existing contract for the requested services found within the Draft Statement of Work (SOW)?

☐ YES☐ NO ☐ N/A

If yes is selected, please list contract number(s) and provide ordering instructions.

For questions 5 through 10, interested offerors must provide a description of their experience in providing the requested services, to include: contract numbers, performance period, contract value, customer name, and indication whether interested offeror acted as the prime or a sub under the contract.

Provide your company’s specific and relevant experience with supporting the development and implementation of regulatory actions in accordance with the Family Smoking Prevention and Tobacco Control Act, Administrative Procedure Act (APA) (5 U.S.C. Chapter 5), Congressional Review Act, Paperwork Reduction Act, and the Regulatory Flexibility Act, court rulings, executive orders, and legislative updates. as outlined in Section 3 (Scope) of the DRAFT SOW.