B09_Solicitation_Amendment_1_Attach_1_Experience_Questionnaire_0001.xls

XLS spreadsheet 38 KB Posted

Attached to
BARN SPRINKLER REPAIR SERVICE
Solicitation number
140P6326Q0026
Issued by

About this file

This is an Experience Questionnaire form for the barn sprinkler repair service solicitation issued by the National Park Service Midwest Region for Tallgrass Prairie National Preserve in Strong City, Kansas. The form serves as Amendment 1 to Solicitation Number 140P6326Q0026 and corrects a typographical error on the original questionnaire.

The questionnaire requires prospective contractors to provide comprehensive information including company name, address, contact details, business structure (corporation, non-profit, individual, or co-partner), SAM registration, and DUNS number. Contractors must document their relevant experience in years, detail completed projects from the past three years with contract amounts and project types, and list all current contract commitments with completion percentages and dates. The form requires disclosure of any failure to complete awarded work or use of performance bonds, along with explanations of such circumstances. Additionally, contractors must specify the minimum and maximum number of employees available for the project, confirm regular payroll status, list equipment available, provide detailed qualifications and certifications of principal individuals who will work on the project, and furnish financial responsibility information from a financial institution or submit a letter addressing account status. The questionnaire concludes with a certification statement in which the contractor attests to their intent to complete the project as specified and confirms the accuracy and completeness of all provided information.

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Other files

File Type Posted
Sol_140P6326Q0026_Amd_0001.pdf PDF
B08_Solicitation_Attach_3_Experience_Questionnaire.xls XLS spreadsheet
B08_Solicitation_Attach_2_WD.pdf PDF
B08_Solicitation_Attach_1_SOW.pdf PDF
Sol_140P6326Q0026.pdf 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 DUNS 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
AMOUNTTYPE OF
PROJECTDATE
COMPLETEDNAME, ADDRESS & TELEPHONE NO.TO

CONTACT FOR INFORMATION

6. List all of your firms current contract commitments:
CONTRACT
NUMBERAWARD
AMOUNTNAME, ADDRESS, & PHONE NO.
TO CONTACT FOR INFORMATIONPERCENT
COMPLETEDDATE

COMPLETED

7a. Have you ever failed to complete any work awarded to you?YesNo
7b. Has work ever been completed by performance bond?YesNo
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?YesNo
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
NAMEPRESENT
POSITIONYEARS
EXPERIENCETYPE 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.
SIGNATURETITLEDATE

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

File details come from the government source that posted it. Updated .