Att 05_140P8420Q0039_Technical Info Form_revised_0006.pdf

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Attached to
Paint Home Ranch Residences, NPS-PORE Federal contract opportunity
Solicitation number
140P8420Q0039
Issued by
Department of the Interior National Park Service Pacific West Region

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Text version

TECHNICAL INFORMATION FORM

(Attachment 05) (revised 6/22/2020)

Paint Home Ranch Residences Point Reyes National Seashore

RFQ No.: 140P8420Q0039

Quoters shall submit the following information:

Quoters Business Name: ___________________________________

Quoters Address: ___________________________________

Quoters DUNS: ___________________________________

Quoters Phone: ___________________________________

Quoters Contact Name: ___________________________________

Quoters Signature: ___________________________________

REQUIRED QUALIFICATION:

Is your firm a CA Licensed C-33 Painting Contractor? ___________________________ (proof required – please attach and include with your quote) YES or NO answer

Are you proposing to use a sub-contractor? ___________________________ YES or NO answer

IF you are proposing to use a sub-contractor, list name of sub(s): _______________________________ (proof required of sub’s current CA C-33 Painting License, as well as prime contractor’s current CA Contractor State License classification such as “B” General Building Contractor).

REQUIRED CERTIFICATION:

Is your firm an EPA-certified renovator complying with ___________________________ lead-safe work practices? (proof required – please attach YES or NO answer with your quote, or be verifiable at:

https://cfpub.epa.gov/flpp/pub/index.cfm?do=main.firmSearch)

IF you are proposing to use a sub-contractor, list name of sub(s): _______________________________ (proof required of sub’s current status as EPA-certified renovator complying with lead-safe work practices).

RFQ No. 140P8420Q0039, Attachment 05, Technical Information Form

PAST PERFORMANCE REFERENCES:

Name: ___________________________ Name:____________________________

Business: ___________________________ Business:__________________________

Address: ___________________________ Address:___________________________

Phone Number: ___________________________ Phone Number:_____________________

Name: ___________________________

Business: ___________________________

Address: ___________________________

Phone Number: ___________________________

RFQ No. 140P8420Q0039, Attachment 05, Technical Information Form

LIST OF RELEVANT PROJECTS:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

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