Encl 2 KTR Info Sheet

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

FOR
N40084FY27 IDIQ PREVENTIVE MAINTENANCE AND REPAIR SERVICES FOR U.S. FIRE APPARATUS AT NAVY REGION, JAPAN Use this form to provide contractor’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. Contractor Information:
Firm Name:
Address:

Unique Entity ID: CAGE CODE:

Name of POC for firm:
Phone Number of POC:Email of POC:
Questionnaire:1. Do you have all necessary registration, licenses, and/or certifications to conduct business in Japan in accordance with the draft PWS? If not, which registration, licenses, and/or certifications do you have an issue obtaining and why?

2. Comments or suggestions for the DRAFT PWS

3. Besides Experience and Past Performance, are there any other non-price factors that should be evaluated? Please explain.

4. Do you prefer payment to be denominated in USD or JPY?

5. This space may be used to provide any additional information that is relevant:

742315603250SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

FOR
N40084FY27 IDIQ PREVENTIVE MAINTENANCE AND REPAIR SERVICES FOR U.S. FIRE APPARATUS AT NAVY REGION, JAPAN Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to 3 projects. Please limit response to two pages per project. 1.Contractor Name:
2.Project No. (check one):- 1- 2- 3
3.Contract Number: Delivery/Task Order No.:
Project Number:
Title:
Location:
4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy): Project is % complete (on submission due date) 5.Final Contract Price:¥
(incl. all options and mods)
This is thetotal projectsubcontract price.
6.Type of work:Facilities SupportMaintenance/Overhaul/ Repair/ Alteration services 7.Customer/Owner Name:
Point of Contact Name/Title:
(person with project knowledge)
POC Phone Number:POC Email Address:
8.Were you the Prime contractor for this project?YesNo Were you a subcontractor for this project?YesNo If subcontractor, who was the Prime contractor?
9. Type of Contract (check all that apply):
Firm Fixed-Price (FFP)Indefinite Delivery / Indefinite Quantity (IDIQ) Other (explain):
If partnership, provide the following information:
Partner firm name: Years working together:
Address:

10. Narrative Description of the Project:

11. Percentage of work you self-performed on this project:%. Explain work self-performed: