submittal copy with questionnaire.docx
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- Solicitation number
- AG-435H-S-11-0019
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Submittal Copy with Experience Questionnaire
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| File | Type | Posted |
|---|---|---|
| supplemental specs.pdf | ||
| drawings FSR 12.com.pdf | ||
| PR2 wage determination.pdf | ||
| AG-435H-S-11-0019.pdf |
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REQUEST FOR QUOTATION
PAGE OF PAGES
| (THIS IS NOT AN ORDER) |
| THIS RFQ |
| X |
| IS |
IS NOT A SMALL BUSINESS SET- ASIDE
| 1. REQUEST NO. |
| 2. DATE ISSUED |
| 3. REQUISITION/PURCHASE REQUEST NO. |
| 4. CERT. FOR NAT.DEF. |
UNDER BDSA REG. 2
AND/OR DMS REG. 1
RATING
| AG-435H-S-11-0019 |
| 8/5/2011 |
| 532028 |
| 5a. ISSUED BY |
| 6. DELIVER BY (Date) |
USDA Forest Service Chattahoochee-Oconee National Forest 1755 Cleveland Highway, Gainesville GA 30501 120 calendar days after effective date of Notice to Proceed
| 5b. FOR INFORMATION CALL (NO COLLECT CALLS) |
| DESTINATION: |
El Yunque National Forest Rio Grande PR
| NAME |
| TELEPHONE NUMBER |
Administrative: ------- Marcia O’Connor
Technical: ------- Edgardo Martinez 770-297-3055 moconnor@fs.fed.us 787-888-5659 efmartinez@fs.fed.us
| 10. Please furnish quotations to the issuing office in block 5A on or before close of business: |
| IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in BLOCK 5A. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter. |
August 30, 2011
Fax quotes accceptable 770-297-3031 Or email to moconnor@fs.fed.us
11. SCHEDULE (Include applicable Federal, State and local taxes)
| ITEM NO. |
| SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| (a) |
| (b) |
| (c) |
| (d) |
| (e) |
| (f) |
Road Repair and Maintenance of FSR 12, Palo Hueco Road, in accordance with attached terms and conditions.
A site showing is schedule for Aug 16. Meet at 9:30am at the Catalina Service Center, PR Route 191, km 4.3.
Call 787-888-1880 for details.
Contractors shall complete and return pages 1 and 2 and the experience questionnaire.
Enter total from page 2
| a. 10 CALENDAR DAYS (%) |
| b. 20 CALENDAR DAYS |
| c. 30 CALENDAR DAYS |
| d. CALENDAR DAYS |
12. DISCOUNT FOR PROMPT PAYMENT
| NUMBER |
| PERCENTAGE |
NOTE: Additional provisions and representations [ X ] are [ ] are not attached.
| 13. NAME AND ADDRESS OF QUOTER |
| 14. Signature of person authorized to sign quotation |
| 15. DATE OF |
a. NAME OF QUOTER
QUOTATION
| b. STREET ADDRESS |
| 16. SIGNER |
| a. NAME (Type or print) |
| b. TELEPHONE |
| d. CITY |
| e. STATE |
| f. ZIP CODE |
AREA CODE
| TAXPAYER ID NUMBER (SSN OR TIN) |
| DUNS NUMBER If assigned |
| c. TITLE (Type or Print) |
| NUMBER |
NSN 7540-01-152-8084
Previous edition not usable
| 18-121 |
| STANDARD FORM 18 (Rev. 6-95) |
Prescribed by GSA-FAR (48 CFR) 53.215-1(a)
AG-435H-S-11-0019
El Yunque NF, Palo Hueco Road FSR 12 Reconditioning
AG-435H-S-11-0019
El Yunque NF, Palo Hueco Road FSR 12 Reconditioning
Supplies or Services and Prices/Costs Schedule of Items
| Item |
| DESCRIPTION |
| Quantity |
| Units |
| Unit Price |
| Cost |
| 151(01) |
| Mobilization |
| All |
| LS |
| $ |
| $ |
| 152(56) |
| Construction survey and staking |
| All |
| LS |
| $ |
| $ |
| 154(01) |
| Contractor Testing |
| All |
| LS |
| $ |
| $ |
| 157(07) |
| Bales, hay or straw |
| 30 |
| each |
| $ |
| $ |
| 203(02) |
| Removal of culvert |
| 1 |
| each |
| $ |
| $ |
| 204(16) |
| Waste, excess excavation |
| 150 |
| m3 |
| $ |
| $ |
| 204(19) |
| Drainage excavation, type lead-off ditch |
| 100 |
| m |
| $ |
| $ |
| 204(20) |
| Drainage excavation, type rolling dip |
| 5 |
| each |
| $ |
| $ |
| 251(01) |
| Placed riprap, class 1 |
| 20 |
| m3 |
| $ |
| $ |
| 303(11) |
| Road reconditioning, surfacing, |
Compaction method B
| 1.475 |
| km |
| $ |
| $ |
| 322(03) |
| Aggregate base, grading B, |
Compaction method D
| 220 |
| m3 |
| $ |
| $ |
| 322(11)a |
| Aggregate surface course, grading A, |
Compaction method B
| 205 |
| m3 |
| $ |
| $ |
| 322(11)b |
| Aggregate surface course, grading AASHTO |
No. 4, Compaction method A
| 142 |
| m3 |
| $ |
| $ |
| 404(03) |
| Minor Hot Asphalt Concrete |
| 1460 |
| m2 |
| $ |
| $ |
| 601(01) |
| Concrete, method A |
| 3.2 |
| m3 |
| $ |
| $ |
| 602(58) |
| 457 mm Reinforced concrete pipe, class III |
| 12 |
| m |
| $ |
| $ |
| 604(03) |
| Inlet, concrete box |
| 1 |
| each |
| $ |
| $ |
| 607(08) |
| Cleaning culverts in place |
| 5 |
| each |
| $ |
| $ |
| 623(01) |
| General labor |
| 48 |
| h |
| $ |
| $ |
TOTAL
EXPERIENCE QUESTIONNAIRE
Instructions: See Item No. 10, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address & Telephone No.
2. Type of Business __Company __Co-Partner __Corporation __Individual __Non-profit
3. How many years experience do you have in this line of work____Yrs
4. How many years experience as a prime contractor_____ subcontractor___
5. List the relevant current/past projects for your business in the last 3 years:
a. Project (Location): ____________________________________________________________________________________
Contract Amount $______________________________________ Period of Performance______________________________
Description of Services (i.e. type of road, length of road, equipment used, tasks performed, trades involved) _______________________________________________________________________________________________________
Name, Address & Telephone Number for Point of Contact for Information:
b. Project (Location): ____________________________________________________________________________________
Contract Amount $______________________________________ Period of Performance______________________________
Description of Services (i.e. type of road, length of road, equipment used, tasks performed, trades involved) _______________________________________________________________________________________________________
Name, Address & Telephone Number for Point of Contact for Information:
c. Project (Location): ____________________________________________________________________________________
Contract Amount $______________________________________ Period of Performance______________________________
Description of Services (i.e. type of road, length of road, equipment used, tasks performed, trades involved) _______________________________________________________________________________________________________
Name, Address & Telephone Number for Point of Contact for Information:
Attach supplemental sheets if space is not sufficient above
d. Project (Location): ____________________________________________________________________________________
Contract Amount $______________________________________ Period of Performance______________________________
Description of Services (i.e. type of road, length of road, equipment used, tasks performed, trades involved) _______________________________________________________________________________________________________
Name, Address & Telephone Number for Point of Contact for Information:
e. Project (Location): ____________________________________________________________________________________
Contract Amount $______________________________________ Period of Performance______________________________
Description of Services (i.e. type of road, length of road, equipment used, tasks performed, trades involved) _______________________________________________________________________________________________________
Name, Address & Telephone Number for Point of Contact for Information:
6. Have you ever failed to complete any work awarded to you? __yes __ no
If "yes" to the question above, specify location(s) and reason(s) why
7. Contract Management:
a. No. of employees: .b. Are employees regularly on your payroll: __yes __ no
c. Specify contractor owned equipment (indicate size & capacity) to be used for this contract
d. Tasks to be subcontracted. List task and subcontractor name, address, and contact information
e. Provisions to secure additional equipment or personnel:
f. Past experience in managing multiple contracts simultaneously:
(PLEASE NOTE ADDITIONAL SHEETS MAY BE ATTACEHD TO SUPPLEMENT THIS FORM)
8. N/A
9. N/A
10. List the experience of the principal individuals of your business
| INDIVIDUALS NAME |
| PRESENT POSITION |
| YRS EXP |
| TYPE OF WORK |
11. Information required to complete a financial responsibility determination if the apparent successful offeror.
a. Credit References
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
b. Banking Information.
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
12. REMARKS: (PLEASE NOTE ADDITIONAL SHEETS MAY BE ATTACHED TO SUPPLEMENT THIS FORM)
CERTIFICATION: I certify that all of 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 Forest Service with any information needed to verify my capability to perform this project:
Name:
| Title: |
| Date: |
File details come from the government source that posted it. Updated .