Atch_2_Technical-Experience_Questionnaire.xls

XLS spreadsheet 38 KB Posted

Attached to
IMRO THREATT FILLING STATION NHL NOMINAT
Solicitation number
140P1226Q0033
Issued by

About this file

This is a Technical/Experience Questionnaire template designed for contractors bidding on federal contract opportunities with the National Park Service (NPS), specifically for the Threatt Filling Station National Historic Landmark (NHL) nomination project under solicitation 140P1226Q0033 issued by the Department of the Interior National Park Service Intermountain Region.

The questionnaire requires contractors to provide comprehensive information about their qualifications and capacity to perform NHL nomination work. Key submission requirements include: contractor identification and business type (corporation, non-profit, individual, or co-partner); years of general experience and experience as a prime contractor; a detailed listing of NHL nomination contracts completed within the last five years, including contract amounts, project types, completion dates, and reference contacts; all current contract commitments with award amounts and completion percentages; disclosure of any failed project completions or work completed under performance bonds with supporting explanations; organizational capacity information including minimum and maximum available employees, payroll status, and equipment availability; names, positions, years of experience, and type of work for principal individuals with required qualifications and certifications; and financial responsibility documentation from a financial institution or alternative letter addressing account status and standing. The form includes a certification statement in which the contractor attests to their intent to complete the project as specified, their conformance to solicitation specifications, the accuracy and completeness of all statements provided, and authorization for references to verify capability.

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Sheet1

TECHNICAL/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.
1. Contractors Name, Address, & Telephone No.:2. Type of Business
Name:
Address:Company
Corporation
Non-profit Org
Telephone No.:Co-partner
SAM UEI No: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 National Historic Landmark (NHL) nomincation contracts: inclusive of consulting, coordinating, and preparing key components of the NHL nominations in the last 5 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 service:
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 with proper qualifications/certifications 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 I intend to complete the project as specified and that my offer conforms to the specifications of the solicitation without deviation unless I provide an alternative proposal. 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.
SIGNATURETITLEDATE

Sheet2

Sheet3

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