B09_Solicitation_Amendment_1_Attach_1_Experience_Questionnaire_0001.xls
XLS spreadsheet 38 KB Posted
- Attached to
- BARN SPRINKLER REPAIR SERVICE
- Solicitation number
- 140P6326Q0026
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 | ||
| B08_Solicitation_Attach_3_Experience_Questionnaire.xls | XLS spreadsheet | |
| B08_Solicitation_Attach_2_WD.pdf | ||
| B08_Solicitation_Attach_1_SOW.pdf | ||
| Sol_140P6326Q0026.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 | |||||||
| 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
File details come from the government source that posted it. Updated .