5-Experience Questionnaire.pdf
PDF 29 KB Posted
- Attached to
- 2026 Street Rehab Project
- Solicitation number
- Not on record
- Issued by
- Cumberland County, Pennsylvania
About this file
This Experience Questionnaire is a mandatory submission document for bidders responding to Wormleysburg Borough's 2026 Street Rehab Project in Pennsylvania. The questionnaire requires bidders to provide comprehensive background information including business type, years of construction experience, current service contracts in progress, and details on five or more comparable projects completed within the past five years. Bidders must disclose any contract defaults or failures to complete work, provide reference contacts for verification, and document the construction experience of principal individuals within their organization. All responses must be sworn and notarized to certify accuracy and truthfulness of statements.
The questionnaire is part of a broader competitive bidding process for municipal infrastructure work involving milling, wearing/leveling course installation, drainage pipe replacement, and curb ramp replacement. Bids are due online by July 8, 2026, at 2:00 PM through PennBID, with a 10 percent certified check or bid bond required from all bidders. The contract is subject to Pennsylvania Prevailing Wage Act requirements, OSHA compliance, Pennsylvania Act 229 of 2002, the One Call Act, and the Public Works Employment Verification Act. Successful bidders must demonstrate relevant construction experience and provide bonding through a surety licensed in Pennsylvania, with Wormleysburg Borough reserving the right to accept or reject any or all bids.
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Text version
EXPERIENCE QUESTIONNAIRE 004000 - 1
RETTEW Project No.: 0176401738
DOCUMENT 004000
EXPERIENCE QUESTIONNAIRE
PROJECT IDENTIFICATION Contract 2026-01 – General Construction Rupley Park Improvements Project
CONTRACT
IDENTIFICATION:
0176401738
SUBMITTED TO: WORMLEYSBURG BOROUGH
20 Market Street Wormleysburg, PA 17043
(-Corporation BY: (-Partnership (-An Individual
PRINCIPAL OFFICE ADDRESS
(The signer of this questionnaire guarantees the truth and accuracy of all statements and of all answers to interrogatories hereinafter made.)
1. What type of business is Bidder's organization?
2. How many years has Bidder's organization been performing work, as a contractor or subcontractor, of the type required for this Project?
3. Provide information on all service contracts currently in progress.
Contract Amt. Type of Work
Completed Name and Address of Owner(*) Engineer/
Architect(*)
(*) Provide name of contact person.
EXPERIENCE QUESTIONNAIRE 004000 - 2
4. What five (or more) projects, comparable to this Project, has Bidder's organization completed within the last five years?
Contract Amt. Type of Work
When Completed
Name and Address of Owner (*)
Engineer/ Architect (*)
(*) Provide name of contact person.
5. Has Bidder's organization ever defaulted on any contract or failed to complete any contract?
If so, where and why?
6. List names, addresses, and phone numbers of individuals or organizations that can be contacted by Owner or Engineer to obtain references.
EXPERIENCE QUESTIONNAIRE 004000 - 3
7. What is the construction experience of the principal individuals of Bidder's organization?
Individual’s Name
Present Position or Office
Magnitude and Type of Work In What Capacity?
STATE OF
COUNTY OF
being duly sworn deposes and says that he is of
Title
Name of Organization and that the answers to the foregoing questions and all statements therein are true and correct.
Signature
Sworn to before me this Day of , 20
My commission expires
Signature of Notary Public
Type or print name below each signature.
END OF EXPERIENCE QUESTIONNAIRE
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