Atch_2_Technical-Experience_Questionnaire.xls
XLS spreadsheet 31 KB Posted
- Attached to
- LYJO MONTHLY PEST CONTROL SERVICES Federal contract opportunity
- Solicitation number
- 140P1226Q0034
About this file
This is a Technical/Experience Questionnaire form designed to evaluate contractor qualifications for pest control service contracts with the National Park Service.
The form collects comprehensive information about contractor capability and experience, including general business details (company type, SAM UEI number), years of experience in pest control work and as a prime contractor, and a listing of pest control contracts completed within the last three years with project amounts, types, dates, and reference contacts. Contractors must disclose current contract commitments, including contract numbers, award amounts, completion percentages, and expected completion dates. The form requires disclosure of any failed work completion or performance bond completion, with detailed explanations if applicable. Additional sections address organizational capacity (minimum and maximum employee availability, payroll status, and equipment), qualifications and experience of key personnel assigned to the project, and financial responsibility information or alternative bank letters of reference. The form includes a certification statement wherein contractors affirm their intent to complete the project as specified and confirm the accuracy of all provided information. Contractors may use additional remarks space for supplementary details and must provide authorized references willing to verify their project performance capability.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140P1226Q0034.pdf | ||
| Atch_4_DOL_WD_2015-5293_Rev_32.pdf | ||
| Atch_1_SOW_Pest_Control.docx | DOCX document | |
| Atch_3_Price_Schedule.xlsx | XLSX spreadsheet |
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Text version
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 Pest Control Contracts that were completed in the last 3 years. | |||||||||
| CONTRACT | |||||||||
| AMOUNT | TYPE OF | ||||||||
| PROJECT | DATE | ||||||||
| COMPLETED | NAME, ADDRESS & TELEPHONE NO.TO |
CONTACT FOR INFORMATION
| 6. List all of your firms current contract commitments: | |||||
| CONTRACT | |||||
| NUMBER | AWARD | ||||
| AMOUNT | NAME, ADDRESS, & PHONE NO. | ||||
| TO CONTACT FOR INFORMATION | PERCENT | ||||
| COMPLETED | DATE |
COMPLETED
| 7a. Have you ever failed to complete any work awarded to you? | Yes | No | ||||||||||||
| 7b. Has work ever been completed by performance bond? | Yes | No | ||||||||||||
| 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? | Yes | No | ||||||||||||
| 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 | ||||||||||||||
| NAME | PRESENT | |||||||||||||
| POSITION | YEARS | |||||||||||||
| EXPERIENCE | TYPE 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. | ||||||||||||||
| SIGNATURE | TITLE | DATE |
Sheet2
Sheet3
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