SHEET P

Evaluation criteria is Lowest Price Technically Acceptable (LPTA). PPIRS will be used to determine vendor responsibility.  Potential contractors will be screened for responsibility in accordance with FAR 9.104. 

Please fill out HMDRFQINFO on pages 33-35 of the solicitation.

YOUR COMPANY INFORMATION
YOUR BUSINESS SIZE: ___ Large (LG), ___ Small (SB), ___ Small-Disadvantaged Business (SDB),
___ Veteran-Owned Small Business (VOSB), ___ Women-Owned Small Business (WOSB),
___ Economically Disadvantaged Women-Owned Small Business (EDWOSB), ___ Service Disabled Veteran Owned Small Business (SDOVSB), ___ (HUBZONE), ___ (8a).

QUOTING AS MANUFACTURER? Yes ___   No ___
Name of Quoted Manufacturer ___________________   
QUOTING AS: ___ AUTHORIZED DISTRIBUTOR   or   ___ THIRD PARTY DEALER
Do you have dealer independence? Yes_____ No______  (does the MFR set your prices)
SAM CAGE CODE of MFR: ________________
SHIPPING INFORMATION

PLACE OF MFG/COUNTRY OF ORIGIN: ______/_______ 
ESTIMATED DELIVERY TO PEARL HARBOR__________ Calendar Days ARO
FOB TERMS: DESTINATION 

SHIP TO:                                                       
DoDAAC: N32253
Country Code: USA
PEARL HARBOR NAVAL SHIPYARD IMF
667 SAFEGUARD STREET, BLDG 167-1 RECV 808-
473-8000X4961
PEARL HARBOR, HI 96860-5033
UNITED STATES

Government Representative, DLA Distribution
Email: distrcustomerservice@dla.mil                
Phone: 808-473-8000 X4961