CUSTOMS AND BORDER PROTECTION (CBP)

SMALL BUSINESS - QUESTIONNAIRE

Section I - Contact Information
Contact Name / Date
Company Name
& Address
Telephone
Fax
E-Mail
Ownership: (Please Circle Type of Organization)
Small Disabled VeteranSection 8(a)HUBZone
Small BusinessWoman-Owned
Please provide the name, number, email and address of your Small Business Administration (SBA) representative.
Provide a synopsis of what service/supplies you provide.
Section II - Business Information Section
Dun & Bradstreet Number
TIN (Taxpayer’s Identification Number)
Business License
NAICS CODE (North American Industry Classification System)
Registered in CCR (Central Contractor Registration)
PPIRS System (Past Performance Information Retrieval System)
Is your company in the Mentor Protégé Program or an established relationship with a large business prime? Yes □ No □
If “Yes”, who is the large business and who is the contract with?
Does your company have any established contracts with the Federal Government or other entities? Yes □ No □
If “Yes”, who are those contracts with and who are your references or POC’s (Point of Contacts)? Who are the Contracting Officers and Technical POC’s?
What types of contracts does your company currently have in place?
General Services Administration (GSA), Government Wide Contracts (GWACS), Indefinite Quantity Indefinite Delivery (IDIQ), Firm Fixed Price (FFP), Time & Material, etc
Is your company a sub-contractor on any contracts? Yes □ No □
If “Yes”, with who and what product or service (PSC) are you providing?
Has your company received any small business awards over the past 5 years? Yes □ No □
If “Yes”, please describe.
Has your company provided a presentation to any business or organization over the past five years? Yes □ No □
If “Yes”,provide the POC’s.
Has your company attended any trade shows, outreach sessions, or seminars designed to grow your business within the past 5 years? Yes □ No □
If “Yes”,provide the shows, locations, dates, POC’s and objective of the event.
Where do you envision your company being in the next 5 years?
What is your company’s plan to get there?
Please include a PowerPoint presentation (not to exceed 10 pages) that highlights your company’s product or services and describes your company’s major achievements.

Your information will be electronically filed and reviewed quarterly to determine if your products or services match the demands of the agency. If a match is identified, we will contact you to receive additional information.

Thank you for taking the time to share this valuable information. Please send updates as needed to the Small Business Specialist

Sources seek business information: DHSopenforbusiness

Please forward the completed questionnaire to Ms. Linda Marchal at . She can also be reached at 317-614-4577.

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12/3/2018