B08_Atch_3_Experience_Questionnaire.xls
XLS spreadsheet 38 KB Posted
- Attached to
- BADL Solid Waste Collection Federal contract opportunity
- Solicitation number
- 140P6325Q0003
About this file
This is an Experience Questionnaire template attachment that contractors must complete to demonstrate their qualifications and past performance for a solid waste collection contract at Badlands National Park (BADL). The questionnaire requires contractors to provide their business information, years of experience, completed projects from the last 3 years, current contract commitments, available personnel and equipment, key personnel qualifications, and financial references.
The form includes 11 sections requesting specific details about the contractor's capabilities, including: organizational structure, failure to complete work history, staffing levels, equipment availability, and principal staff experience. Contractors must certify that their responses are accurate and that they intend to complete the project according to specifications. The questionnaire appears to be part of solicitation 140P6325Q0003 issued by the Department of Interior National Park Service Midwest Region for solid waste collection services.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140P6325Q0003.pdf | ||
| B08_Atch_5_DOL_Wage_Determination_2015-5367_Pennington_12_23_24.pdf | ||
| B08_Atch_2_Price_Schedule.xlsx | XLSX spreadsheet | |
| B08_Atch_4_DOL_Wage_Determination_2015-5377_Jackson_12_23_24.pdf | ||
| B08_Atch_1_SOW.pdf |
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Text version
Sheet1
| 1. Contractors Name, Address, & Telephone No.: | 2. Type of Business | ||||||
| Name: | |||||||
| Address: | Company | ||||||
| Corporation | |||||||
| Non-profit Org | |||||||
| Telephone No.: | Co-partner | ||||||
| SAM UEI No: | Individual | ||||||
| 3. How many years experience do you have in this line of work? | Years | ||||||
| 4. How many years experience as a prime contractor? | Years | ||||||
| 5. List the projects your business has completed in the last 3 years: | |||||||
| CONTRACT | |||||||
| AMOUNT | TYPE OF | ||||||
| PROJECT | DATE | ||||||
| COMPLETED | NAME, ADDRESS & TELEPHONE NO.TO |
CONTACT FOR INFORMATION
| 6. List all of your firms current contract commitments: | |||||
| CONTRACT | |||||
| NUMBER | AWARD | ||||
| AMOUNT | NAME, ADDRESS, & PHONE NO. | ||||
| TO CONTACT FOR INFORMATION | PERCENT | ||||
| COMPLETED | DATE |
COMPLETED
| 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 locations and reason why: | ||||||||||||||
| 8. Organization that will be available for this project: | ||||||||||||||
| a. Minimum No. of employees: | and maximum No. of employees: | |||||||||||||
| b. Are employees regularly on your payroll? | Yes | No | ||||||||||||
| c. Specify equipment available for this project: | ||||||||||||||
| 9. List the experience of principal individuals with proper qualifications/certifications to be used on this project: | ||||||||||||||
| INDIVIDUALS | ||||||||||||||
| NAME | PRESENT | |||||||||||||
| POSITION | YEARS | |||||||||||||
| EXPERIENCE | TYPE OF WORK | |||||||||||||
| 10. Financial Responsibility: | ||||||||||||||
| (in lieu of this, you may submit a letter from your | ||||||||||||||
| financial institution that addresses the status and standing of your accounts) | ||||||||||||||
| Name of Financial Institution | ||||||||||||||
| Address: | ||||||||||||||
| Contact Name | ||||||||||||||
| Contact Phone Nbr | ||||||||||||||
| 11. Remarks | ||||||||||||||
| CERTIFICATION: I certify that I intend to complete the project as specified and that my offer conforms to the specifications of the solicitation without deviation unless I provide an alternative proposal. All 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 National Park Service with any information needed to verify my capability to perform this project. | ||||||||||||||
| SIGNATURE | TITLE | DATE |
EXPERIENCE QUESTIONNAIRE
Instructions: This form may be completed manually or by using MS Excel. See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
Sheet2
Sheet3
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