B09_Solicitation_Amendment_2_attach_1_Experience_Questionaire_0002.xls

XLS spreadsheet 38 KB Posted

Attached to
PECO - REPLACE SIDING AND FOUR HVAC UNIT Federal contract opportunity
Solicitation number
140P6326Q0034
Issued by
Department of the Interior National Park Service Midwest Region

About this file

This is an Experience Questionnaire form used to evaluate contractor qualifications for construction services. The National Park Service requires prospective contractors to complete this document as part of the solicitation process for the PECO project at Pecos National Historic Park, which involves removing and replacing siding and four HVAC units.

The questionnaire collects essential contractor information including business type, UEI number, years of experience in the trade and as a prime contractor, and a detailed history of remodel and HVAC projects completed within the past five years with project amounts, types, completion dates, and references. Contractors must also disclose current contract commitments, including contract numbers, award amounts, percent completion, and expected completion dates. The form requires contractors to declare any prior failures to complete awarded work or instances where performance bonds were necessary, along with explanations if applicable. Additional evaluation criteria include staffing availability and capacity (minimum and maximum employee numbers), payroll status, and specialized equipment available for the project. Contractors must provide the experience and qualifications of principal individuals assigned to the project, including their positions, years of experience, and types of work performed. Financial responsibility documentation is required, either through direct submission of financial institution details or an alternative letter addressing account status and standing. The form includes a certification statement affirming the accuracy of submitted information and authorizing references to verify contractor capability. Contractors may submit responses manually or using the provided MS Excel template.

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Text version

Sheet1

1. Contractors Name, Address, & Telephone No.:2. Type of Business
Name:
Address:Company
Corporation
UEI #:Non-profit Org
Telephone No.:Co-partner
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 remodel/HVAC projects your business has completed in the last 5 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 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 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.
NAMETITLEDATE

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 .