QUOTE_SUBMISSION_QUESTIONAIRE.docx

QUOTE SUBMISSION QUESTIONAIRE

☐ Completed Schedule of Items (Section B) (pages2-3) with proposed pricing and/or contractor pricing sheet with all Line Items Priced.

☐ Quoter confirms the attached Scope of Work (SOW) has been thoroughly reviewed before submitting a quotation, including Quote Submission Instructions in Section K, L and M

☐ The active registration in the System for Award Management (SAM) - www.SAM.gov .

☐ Quoter confirms the provision FAR 52.204-8, the annual representations and certifications, has been electronically completed at www.SAM.gov. The complete provision is attached in Section K.

☐ Contract Federal Tax ID Number is provided:__________________________

☐ Contractor DUNS number is provided:_________________________

Proof of General Insurance and Bonding Capability, in accordance with FAR 52.228-5 and FAR 52.228-13;

☐ IS provided (1 page allowed each) OR ☐ CAN be provided before contract award.

Contractor’s Point of Contact (POC) Information is provided:

Name/Position: Email:

Phone: Fax:

☐ The following questions have been answered as provided below (maximum of 1 additional page allowed for each question, if necessary):

1. How many years of experience does the contractor have with working with Tritium Gas EXIT signs and the installation of new LED type EXIT signs? Are you licensed in the state of Montana for this type of work?

2. Do you have any other Job Corp or any other Government Contracting experience? If so, where?

3. Within the past 5 years have you failed to complete any work awarded to you or been terminated for default or breach of contract? If yes, explain.

4. A Bid Bond is not required to be submitted with the quote, but a Payment Bond is required for 100% of the value to the awarded contractor, will the contractor be able to secure this within ten days of award?

5. The USDA requires that all construction contract include BioBased Products, and items have been identified in Section C.8 of the SOW, does your company use these Biobased Products, if so please identify which ones? If others are required, please identify those as well.

6. Did you conduct a site visit?

☐ The following three (3) professional references of similar past work performance is provided:

1. Name: Organization:

Phone: Email:______________________________________

2. Name: Organization:

Phone: Email:______________________________________

3. Name: Organization:

Phone: Email:

☐ I certify that all of the information provided above is complete, true, and correct to the best of my knowledge.

Sign:______________________________________ Date:_______________________________________

AG-82A7-S-14-0085 EXIT sign Replacement – Anaconda Job Corps Center Page 1 of 2