Attachment_D_-_Technical_Evaluation_Experience_Questionnaire.docx

Attachment D. Technical Evaluation/Experience Questionnaire

PAST PERFORMANCE & EXPERIENCE form List projects completed over the past 3 years that are similar to the solicited requirements.

Title and Location of Project

Year Completed

Project Owner (agency or firm that work was done for)

Project Owner Point of Contact Name and Phone Number

Brief Description of Project and relevance to this contract. Indicate scope, size, cost, principle elements, special features, & whether you were the prime or sub on this project.

OFFEROR'S NAME:________________________ DATE: __________________________

equipment form List all equipment that will be used to complete the project requirements.

MAKE

OFFEROR'S NAME:_____________________ DATE: _____________________________

PERSONNEL form List personnel assigned to the project.

NAME

POSITION

OFFEROR'S NAME:____________________ DATE: ______________________________

Sustainable Acquisition Plan List each type of products that you use in your business that support sustainable acquisition in the following categories

Non Ozone Deplelting Substances www.epa.gov/ozone/snap/index.html

Alternative Fuel Vehicles and Alternative Fuels http://www.afdc.energy.gov/fuels/

Water Efficient Products www.epa.gov/watersense

Electronic Products Environmental Assessment Tool (EPEAT) Products www.epeat.net

Energy Efficient Products ie Energy Star, FEMP Designated, and Low Standby Power www.energystar.gov/products

Environmentaly Preferable Products

(EPP)

www.epa.gov/epp

USDA Biiobased and Biopreferred Products http://www.biopreferred.gov

PROJECT MANAGEMENT, QUALITY CONTROL PLAN, SAFETY PLAN (INCLUDE ADDITIONAL PAGES AS NEEDED): _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

OFFEROR'S NAME:________________________ DATE: _________________________