Q--Radiologist Locum St. Cloud, MN

MARKET RESEARCH QUESTIONNAIRE Radiology Physician Services requirement- VA St. Cloud Health Care System The U.S. Department of Veterans Affairs is conducting market research pursuant to Federal Acquisition Regulation Part 10. It is anticipated a single RFQ will be issued for Radiology Physician Services requirement at the VA St. Cloud Health Care System located in St. Cloud, MN. The Government contemplates awarding a single award contract resulting from the future solicitation. The service requirement will be performed at the St. Cloud VA Medical Center in accordance with the Performance Work Statement. Please answer the following questions: 1. Can your firm provide Radiology Physician Services as either a prime contractor or as a subcontractor in St Cloud, MN. Prime Subcontractor ___________No 2. Has your firm Radiology Physician Services as a prime or subcontractor contractor in the last twelve months successfully? No________ Yes________ If yes please list the contract number(s):___________________________________________________________________________________________________________________________________________________________________________________________________________________ 3. Can your firm recruit Radiology Physicians successfully with as little as 30 days notice. Please take a moment to explain your recruiting capabilities to find qualified providers that can make it through the VA credentialing process (you may use an attachment if necessary). Is your firm an established business with experience in providing Radiology Physicians? Can you please identify an hourly rate that your firm charges for these services? Hourly Rate: ______ Daily Per Diem Rate: Daily Travel Rate: Daily Lodging Rate: 3. The North American Industrial Classification System (NAICS) code 561320 Temporary Health Services, which sets the small business size standard at $27.5 million. (greater than $27.5 million is considered large business) Based on this standard, what is your business size, small or large? Small Large 4. If you are a small business, what level of subcontracting, if any, would be available for the service you are interested in providing? % 5. Is your firm eligible for participation in one of the following small business programs? If so, please indicate the program. 8(a) program Women-owned small business concern Economically Disadvantaged Women-owned small business concern Veteran-owned small business concern Service-disabled veteran-owned small business concern Use of a price evaluation adjustment for a small disadvantaged business concern 6. How many calendar days does your firm need to prepare a quotation resulting from this solicitation? ___ 15 days 30 days 45 days ____Less than 15 days 7. Is your company registered in the System for Award Management (www.sam.gov)? Yes No 8. Please furnish the following information in reference to your firm: Name: Point of Contact: Telephone Number: E-mail Address: ____________________________________________________________ I am extremely appreciative of the time you have taken to complete this questionnaire. Please email your completed questionnaire to Daniel Reinke at [email protected] by the closing date indicated. If you have any questions please don t hesitate to contract me at [email protected] Sincerely, Daniel Reinke, Contract Specialist U.S. Department of Veterans Affairs Network Contracting Office 23 (NCO 23) 316 N Robert ST St. Paul, MN 55101 NOTE: Completing this market research questionnaire is completely voluntary and is not reimbursable.