Atch_2_Experience_Questionnaire.xls

XLS spreadsheet 38 KB Posted

Attached to
Curecanti National Recreation Area-Septic Pump Tru
Solicitation number
140PP027Q0014
Issued by
Not on record

About this file

This is an Experience Questionnaire form used by the National Park Service to evaluate contractor qualifications and capability for federal contract performance. The form requires contractors to provide comprehensive information including business type and contact details, years of experience in their line of work and as a prime contractor, and a detailed list of projects completed within the last three years with contract amounts and reference contacts. Contractors must disclose all current contract commitments with award amounts and completion status, and answer questions regarding any failure to complete awarded work or reliance on performance bonds, with explanations required if applicable. The form also requests organizational capacity information such as minimum and maximum employee availability, payroll status, and equipment available for the project.

Additionally, the questionnaire requires contractors to list principal individuals assigned to the project with their positions and relevant experience, provide financial responsibility documentation through either a financial institution letter addressing account status or direct financial institution contact information, and include any additional remarks in the designated space. The form concludes with a certification statement in which the contractor attests to the accuracy and completeness of all provided information and authorizes references to verify capability to perform the project. This questionnaire is associated with Solicitation Number 140PP027Q0014 for Curecanti National Recreation Area Septic Pump Truck Tank Replacement work.

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Other files

File Type Posted
Sol_140PP027Q0014.pdf PDF
Atch_3_DOL_Wage_Determination_2015-5435.pdf PDF
Atch_1_SOW.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
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 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 .