SF 1403 Preaward Survey of Prospective Contractor (General)

PREAWARD SURVEY OF PROSPECTIVE CONTRACTOR

1. SERIAL NO. (For surveying activity use)

OMB Control Number: 9000-0011
Expiration Date: 12/31/2013

(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 Regulatory Secretariat (MVCB),
Office of Acquisition Policy, GSA, 1800 F Street, NW, Washington, DC 20405.

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

14B. POINT OF CONTACT

15B. SIGNATURE

16A. NAME OF CONTACT POINT AT REQUESTING ACTIVITY (If different from Item 15A)

14A. PLANT AND LOCATION (If different from Item 7, above)

14C. TELEPHONE NO. (with area code)

15C. TELEPHONE NO. (Include AUTOVAN, WATS or FTS, if available)
17. RETURN PREAWARD SURVEY TO THIS ADDRESS:

ATTN:
18A.
ITEM
NO.

16B. TELEPHONE NO. (Include AUTOVON, WATS, or FTS, if available)

SECTION II - DATA (For Completion by Contracting Office)

18B. NATIONAL STOCK NUMBER
(NEW) AND NOMENCLATURE

18C. TOTAL
QUANTITY
SOLICITED
OFFERED

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
AUTHORIZATION FOR LOCAL REPRODUCTION
Previous edition is usable.

$
$
$
$
STANDARD FORM 1403 (REV. 12/2013)
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. PRODUCTION CAPABILITY

B. TRANSPORTATION

C. QUALITY ASSURANCE CAPABILITY

C. PACKAGING

D. FINANCIAL CAPABILITY

D. SECURITY

E. ACCOUNTING SYSTEM

E. SAFETY

21. IS THIS A SHORT FORM PREAWARD REPORT? (For completion
by surveying activity)

F. ENVIRONMENTAL/ENERGY CONSIDERATION

YES

UNCHK. SAT. SAT.
(c)
(a)
(b)

G. FLIGHT OPERATIONS/FLIGHT SAFETY

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. 12/2013) BACK