Attachment 05 Experience Questionaire.docx
DOCX document 68 KB Posted
- Solicitation number
- 12445021Q0040
- Issued by
-
Department of Agriculture Forest Service
About this file
This document contains an experience questionnaire for a federal contract opportunity to provide HVAC maintenance services at the International Institute of Tropical Forestry in Puerto Rico. The solicitation number is 12445021Q0040 and is seeking preventive maintenance including four quarterly in-depth inspections and eight monthly inspection visits each year. Services include changing filters, adjusting thermostats and vents, lubricating parts, and minor repairs. Offerors must provide details on relevant past projects, current commitments, bonding and failures to complete work, personnel and equipment available, and references for a responsibility determination. The required response includes company information, experience on similar projects, financial records, and a certification of complete and correct statements.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 03 IITF HVAC Maint SOW (Updated from Q A) 08 Sept. 21.docx | DOCX document | |
| 12445021Q0040 Amend 003.pdf | ||
| Amendment 0002 12445021Q0040.pdf | ||
| 12445021Q0040 Amend 001.pdf | ||
| Attachment 01 Schedue of Items.xlsx | XLSX spreadsheet | |
| Attachment 03 IITF HVAC Maint SOW.docx | DOCX document | |
| Attachment 04 AC System Inventory.xlsx | XLSX spreadsheet | |
| Attachment 02 Wage Rates.pdf | ||
| 12445021Q0040 IITF HVAC Maintenance.pdf | ||
| DRAFT_SOW_IITF_HVAC_Maintenance_21Jul21.docx | DOCX document |
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Text version
Solicitation No: 12445021Q0040 IITF HVAC Maintenance Attachment 05
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
| 1. Contractors Name, Address & Telephone No. Email | |
| 2. Type of Business | |
| Company | Co-Partner Non-profit |
Corporation Individual
| 3. How many years of experience do you have in this line of work | Yrs |
| 4. How many years of experience as a prime contractor | subcontractor |
5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:
CONTRACT
NUMBER
AWARD
AMOUNT
| NAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION. |
| DATE |
CONTRACT
COMPLETED
DESCRIPTION OF WORK PERFORMED
6. List all of your firms current contract commitments CONTRACTPERCENT COMPLETED
NAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.
AWARD AMOUNT
NUMBER
| 7a. Have you ever failed to complete any work awarded to you? | yes | no |
| 7b. Has work ever been completed by performance bond? | yes | no |
7c. If "yes" to either item 7a or 7b specify location(s) and reason(s) why
8. Organization information available for this project:
a. Minimum # of employees: and Maximum # of employees:
b. Are employees regularly on your payroll: yes no
c. Specify equipment available for this contract:
d. Estimate rate of progress (such as 2.0 acres per day):
1. Minimum progress rate: Maximum progress rate
9. List the experience of the principal individuals of your business
| INDIVIDUALS NAME |
| PRESENT POSITION |
| YRS EXP |
| TYPE OF WORK |
10. Information required to complete a responsibility determination if the apparent successful offeror.
a. Credit References
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
b. Banking Information.
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
11. REMARKS
CERTIFICATION: I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project:
| Name: |
| Title: |
| Date: |
File details come from the government source that posted it. Updated .