Project Experience Questionnaire_Fillable_rev1.pdf

PDF 61 KB Posted Mar 24, 2022

Attached to: Atlanta Gate & Barrier Wedge Maintenance Federal contract opportunity
Solicitation number: 70FBR422Q00000031
Issued by: Federal Emergency Management Agency Region 4

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Other files for this federal contract opportunity

Other files attached to Atlanta Gate & Barrier Wedge Maintenance, newest first.
File	Type	Posted
Wage Determinations.pdf	PDF	Mar 24, 2022
Statement of Work 3-24-2022.pdf	PDF	Mar 24, 2022
Solicitation - 70FBR422Q00000031 - SAM.pdf	PDF	Mar 24, 2022
PHOTOS - Rhodes Gates.pdf	PDF	Mar 24, 2022

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PROJECT EXPERIENCE QUESTIONNAIRE

(Offerors must complete this form for evaluation purposes)

NAME OF FIRM POINT OF CONTACT

TELEPHONE NO. EMAIL ADDRESS OR FAX

NO.

PRIOR PROJECT EXPERIENCE

(TO BE COMPLETED BY THE OFFEROR - LIST UP TO FIVE (5) INDIVIDUAL PROJECTS)

PROJECT DESCRIPTION

(USE BLANK PAGE IF NECESSARY) CONTRACT/PROJECT

NO.

LOCATION

CONTRACT AMOUNT (ROUND

TO NEAREST DOLLAR)

ORIGINAL FINAL

1. $ $

2. $ $

3. $ $

4. $ $

5. $ $

NAME OF OWNER/AGENCY POINT OF CONTACT TELEPHONE NO. FACSIMILE NO.

ORIGINAL PROJECT DATES WERE YOU A PRIME CONTRACTOR

OR SUBCONTRACTOR?

WERE THERE

CONTRACT

MODIFICATIONS?

(YES/NO)

HOW MANY?

WHO INITIATED

THEM? CLIENT OR

CONTRACTOR? START COMPLETION

WERE THERE ANY

TIME EXTENSIONS?

(YES/NO)

IF SO, INDICATE

TOTAL EXTENDED

DAYS?

WAS THE

SCHEDULE MET?

(YES/NO)

IF NOT, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

HAVE YOU EVER

ENTERED A

DISPUTE? (YES/NO)

IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

HAVE YOU EVER

BEEN DEFAULTED?

(YES/NO)

IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

NAME OF FIRMRow1:

POINT OF CONTACTRow1:

TELEPHONE NO:

EMAIL ADDRESS OR FAX NO:

CONTRACTPROJECT NO1:

LOCATION1:

fill_85:

fill_86:

CONTRACTPROJECT NO2:

LOCATION2:

fill_87:

fill_88:

CONTRACTPROJECT NO3:

LOCATION3:

fill_89:

fill_90:

CONTRACTPROJECT NO4:

LOCATION4:

fill_91:

fill_92:

CONTRACTPROJECT NO5:

LOCATION5:

fill_93:

fill_94:

POINT OF CONTACT1:

TELEPHONE NO1:

FACSIMILE NO1:

POINT OF CONTACT2:

TELEPHONE NO2:

FACSIMILE NO2:

POINT OF CONTACT3:

TELEPHONE NO3:

FACSIMILE NO3:

POINT OF CONTACT4:

TELEPHONE NO4:

FACSIMILE NO4:

POINT OF CONTACT5:

TELEPHONE NO5:

FACSIMILE NO5:

COMPLETION1:

WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR1:

WERE THERE CONTRACT MODIFICATIONS YESNO1:

HOW MANY1:

WHO INITIATED THEM CLIENT OR CONTRACTOR1:

COMPLETION2:

WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR2:

WERE THERE CONTRACT MODIFICATIONS YESNO2:

HOW MANY2:

WHO INITIATED THEM CLIENT OR CONTRACTOR2:

COMPLETION3:

WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR3:

WERE THERE CONTRACT MODIFICATIONS YESNO3:

HOW MANY3:

WHO INITIATED THEM CLIENT OR CONTRACTOR3:

COMPLETION4:

WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR4:

WERE THERE CONTRACT MODIFICATIONS YESNO4:

HOW MANY4:

WHO INITIATED THEM CLIENT OR CONTRACTOR4:

COMPLETION5:

WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR5:

WERE THERE CONTRACT MODIFICATIONS YESNO5:

HOW MANY5:

WHO INITIATED THEM CLIENT OR CONTRACTOR5:

IF SO INDICATE TOTAL EXTENDED DAYS1:

WAS THE SCHEDULE MET YESNO1:

IF NOT WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY1:

IF SO INDICATE TOTAL EXTENDED DAYS2:

WAS THE SCHEDULE MET YESNO2:

IF NOT WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY2:

IF SO INDICATE TOTAL EXTENDED DAYS3:

WAS THE SCHEDULE MET YESNO3:

IF NOT WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY3:

IF SO INDICATE TOTAL EXTENDED DAYS4:

WAS THE SCHEDULE MET YESNO4:

IF NOT WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY4:

IF SO INDICATE TOTAL EXTENDED DAYS5:

WAS THE SCHEDULE MET YESNO5:

IF NOT WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY5:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY1:

HAVE YOU EVER BEEN DEFAULTED YESNO1:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY1_2:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY2:

HAVE YOU EVER BEEN DEFAULTED YESNO2:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY2_2:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY3:

HAVE YOU EVER BEEN DEFAULTED YESNO3:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY3_2:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY4:

HAVE YOU EVER BEEN DEFAULTED YESNO4:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY4_2:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY5:

HAVE YOU EVER BEEN DEFAULTED YESNO5:

IF SO WHAT WAS THE REASON USE BLANK PAGE IF NECESSARY5_2:

Text1:

Text2:

Text3:

Text4:

Text5:

Text6:

Text7:

Text8:

Text9:

Text10:

Start Date1:

Start Date2:

Start Date3:

Start Date4:

Start Date5:

Extensions1:

Extensions2:

Extensions3:

Extensions4:

Extensions5:

Dispute1:

Dispute2:

Dispute3:

Dispute4:

Dispute5:

File details come from the government source that posted it. Updated Mar 24, 2022.