Q--Offsite Surgery OR (VA-19-00023265)

Page 3 of 3 The purpose for this sources sought notice is to locate interested companies that can furnish the REQUIREMENTS listed in the PWS that is attached. Offeror's capability to meet this requirement including any current contracts (Civilian or Government) to include meeting the below listed accreditations or similar standards, facility description, capabilities, and certifications. Responses must show clear and convincing evidence that your company and its employees have the capabilities, training, and qualifications to provide this service to be considered as a source. The following information is requested in a response to this RFI: 1. General Company information- Offeror's company name, DUNS, full address, point of contact, title, phone number, and email address. Name: ____________________________________________ Address: ____________________________________ ____________________________________ ____________________________________ Contact Person: _______________________________________ Phone number: __________________________________________ Email address: __________________________________________ DUNS number: _________________________________________ Cage Code Number: _______________________________ Company website if available: _______________________________________ 2. Business Type Please put a check mark or circle around the type of business you are below: a) Large b) 8(a) c) HubZone d) Small Business e) Small Disadvantaged Business f) Woman Owned Small Business g) Service Disabled Veteran Owned Small Business h) Veteran Owned Small Business ***Note - All Veteran Owned Businesses must be registered in VetBiz at http://www.vip.vetbiz.gov/general_user/register/default.asp to be considered a Veteran Owned Business. Socioeconomic status (whether Service Disable Veteran Owned Small Business (SDVOSB), Veteran Owned Small Business (VOSB), Hubzone, 8(a), Woman Owned, Small Disadvantaged, etc.). If stating SDVOSB or VOSB status, your company must be verified with the seal/icon or show pending verification in VetBiz Registry (https://www.vip.vetbiz.gov//) to be considered as a SDVOSB or VOSB source. 3. How long has your company provided these services? 4. Provide information for any current or past VA contracts for these products and services. 5. Is your company registered in the System for Award Management at WWW.SAM.GOV? The NAICS code for the procurement is 622110 and the small business size standard is $38.5 Million dollars. Any future RFP will be conducted in accordance with FAR Parts 12 and 15. The Government may elect to award a Firm Fixed Price contract resulting from the solicitation. Responses to this market survey should be e mailed to [email protected] No telephone responses will be accepted. Please provide a detailed response to the below Performance Work Statement stating how you can meet all aspects stated. It is requested that responses be received no later than 3:00 pm Central, January 22nd, 2019. No solicitation document is available now; this notice is to acquire information only. Vendors interested in providing an offer will have to respond to a separate solicitation announcement.