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pdfPREAWARD SURVEY OF PROSPECTIVE CONTRACTOR
1. SERIAL NO. (For surveying activity use)
OMB NO.:9000-0011
Expires:
10/31/97
(GENERAL)
Public reporting burden for this collection of information is estimated to average 24 hours per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to the FAR Secretariat (VRS), Office of Federal Acquisition and Regulatory Policy, GSA, Washington, DC 20405;
and to the Office of Management and Budget, Paperwork Reduction Project (9000-0011), Washington, DC 20503.
SECTION I - REQUEST (For Completion by Contracting Office)
2. NAME AND ADDRESS OF SURVEYING ACTIVITY
3. SOLICITATION NO.
4. TOTAL OFFERED PRICE
$
5. TYPE OF CONTRACT
6A. NAME AND ADDRESS OF SECONDARY SURVEY ACTIVITY
(For surveying activity use)
7A. NAME AND ADDRESS OF PROSPECTIVE CONTRACTOR
6B. TELEPHONE NO. (Include AUTOVON, WATS, or FTS, if available)
7B. FIRM'S CONTACT
8. WILL CONTRACTING OFFICE PARTICIPATE IN SURVEY?
13. NAME AND ADDRESS OF PARENT COMPANY (If applicable)
YES
NO
9. DATE OF REQUEST
7C. TELEPHONE NO. (with area code)
10. DATE REPORT REQUIRED
11. PROSPECTIVE CONTRACTOR REPRESENT THAT IT
SMALL BUSINESS CONCERN.
IS,
IS NOT A
12. WALSHA. IS NOT APPLICABLE
HEALY
B. IS APPLICABLE AND PROSPECTIVE CONTRACTOR
CON
REPRESENTS HIS CLASSIFICATION AS:
ACT
(Check
MANUFACTURER
REGULAR DEALER
applicable
OTHER (Specify)
box(es))
15A. NAME OF REQUESTING ACTIVITY CONTRACTING OFFICER
14A.PLANT AND LOCATION (If different from Item 7, above)
15B. SIGNATURE
16A.NAME OF CONTACT POINT AT REQUESTING ACTIVITY
(If different from Item 15A)
14C. TELEPHONE NO. (with area code)
14B. POINT OF CONTACT
15C. TELEPHONE NO. (Include AUTOVAN, WATS or FTS, if available)
16B. TELEPHONE NO. (Include AUTOVON, WATS, or FTS, if available)
17. RETURN PREAWARD SURVEY TO THIS ADDRESS:
ATTN:
SECTION II - DATA (For Completion by Conracting Office)
18A.
ITEM
NO.
18B. NATIONAL STOCK NUMBER
(NEW) AND NOMENCLATURE
18C. TOTAL
QUANTITY
18D. UNIT
PRICE
18E. DELIVERY SCHEDULE
(a)
(b)
(c)
(d)
(e)
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
$
SOLICITED
OFFERED
AUTHORIZATION FOR LOCAL REPRODUCTION
Previous edition is usable.
$
STANDARD FORM 1403 (REV. 9-88)
Prescribed by GSA FAR (48 CFR) 53.209-1(a)
SECTION III - FACTORS TO BE INVESTIGATED
UNCHK. SAT. SAT.
(c)
(a)
(b)
19. MAJOR FACTORS
20. OTHER FACTORS
(Provide specific requirements in Remarks)
A. TECHNICAL CAPABILITY
A. GOVERNMENT PROPERTY CONTROL
B.
B.
PRODUCTION CAPABILITY
UNCHK. SAT. SAT.
(c)
(a)
(b)
TRANSPORTATION
C.QUALITY ASSURANCE CAPABILITY
C.PACKAGING
D.FINANCIAL CAPABILITY
D.SECURITY
E. ACCOUNTING SYSTEM
21. IS THIS A SHORT FORM PREAWARD REPORT? (For completion
by surveying activity)
E.
SAFETY
F.
ENVIRONMENTAL/ENERGY CONSIDERATION
G.
FLIGHT OPERATIONS/FLIGHT SAFETY
YES
NO
22. IS A FINANCIAL ASSISTANCE PAYMENT PROVISION IN THE
SOLICITATION? (For completion by contracting activity)
H.OTHER
(Specify)
YES
NO
23. REMARKS (For Contracting Activity Use)
SECTION IV - SURVEYING ACTIVITY RECOMMENDATIONS
24. RECOMMEND
25A. NAME AND TITLE OF SURVEY APPROVING OFFICIAL
25B. TELEPHONE NO.
25C. SIGNATURE
25D. DATE
A. COMPLETE AWARD
B.
PARTIAL AWARD
(Quantity
)
C.NO AWARD
STANDARD FORM 1403 (REV. 9-88) BACK
File Type | application/pdf |
File Modified | 2006-11-21 |
File Created | 1995-10-24 |