Sources Sought Contractor Information Form GC Metro

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

for
THE METROPOLITAN SAN DIEGO (NAVAL BASES SAN DIEGO, POINT LOMA, CORONADO, AND MARINE CORPS AIR STATION (MCAS) MIRAMAR), CA, AORS, GENERAL CONSTRUCTION PROJECTS IDIQ JOC 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:
UEI:

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CAGE Code:

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Firm Name:

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Address:

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Name of POC for firm:

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Phone Number of POC:

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Email of POC:

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Type of Business: (check all that apply)
FORMCHECKBOX SBA certified 8(a) firm
FORMCHECKBOX SBA certified HUBZone Small Business
FORMCHECKBOX Service-Disabled Veteran-Owned Small Business FORMCHECKBOX Small Business
FORMCHECKBOX Women-Owned Small Business

Bonding Capacity:
Surety Name:

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Maximum bonding capacity per project:

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Aggregate maximum bonding capacity:

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Locations. Identify the locations you are willing and capable to work: (check all that apply)

FORMCHECKBOX NB SAN DIEGO AOR

FORMCHECKBOX NB POINT LOMA AOR

FORMCHECKBOX MCAS MIRAMAR AOR

FORMCHECKBOX NB CORONADO AOR

If you are not willing and capable to work in locations noted above, explain why not:

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Safety. OSHA Days Away from Work, Restricted Duty, or Transfer (DART) Rate, and Total Recordable Case (TRC) Rate:

CY

DART

TRC
2023

2024

2025

This space may be used to provide any additional information to clarify the above items only:

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Form may be expanded. Please DO NOT change content of the form.

SOURCES SOUGHT – CONTRACTOR INFORMATION FORM

for
THE METROPOLITAN SAN DIEGO (NAVAL BASES SAN DIEGO, POINT LOMA, CORONADO, AND MARINE CORPS AIR STATION (MCAS) MIRAMAR), CA, AORS, GENERAL CONSTRUCTION PROJECTS IDIQ JOC Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to five (5) projects. Please limit response to two pages per project. 1.
Contractor Name:

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2.
Project No. (check one):
FORMCHECKBOX - 1 FORMCHECKBOX - 2 FORMCHECKBOX - 3 FORMCHECKBOX - 4 FORMCHECKBOX - 5 3.
Contract Number:

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Delivery/Task Order No.:

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Project Number:

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Title:

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Location:

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4.
Award Date (mm/dd/yy):

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5.
Final Contract Price:

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Completion Date (mm/dd/yy):

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(includes all options and mods)
Project is FORMTEXT % complete (as of sources sought issuance date) This is the FORMCHECKBOX total project FORMCHECKBOX subcontract price.