Atch_3_Experience_Questionnaire.xls

XLS spreadsheet 31 KB Posted

Attached to
Padre Island National Seashore-Repair Damaged Beac
Solicitation number
140P6326Q0013
Issued by

About this file

This is an Experience Questionnaire form used by the National Park Service to evaluate contractor qualifications for federal contract opportunities.

The form requires contractors to provide comprehensive background information including company details, business structure, and contact information. Contractors must document their relevant experience by specifying years in their line of work and years as a prime contractor, then list specific projects completed within the last three years with contract amounts, project types, completion dates, and reference contacts. The form also requires disclosure of all current contract commitments, including contract numbers, award amounts, percent completion status, and completion dates. Contractors must certify their performance history by indicating whether they have ever failed to complete awarded work or required performance bonds, with explanations if applicable. Additional sections address organizational capacity by requesting minimum and maximum employee availability, payroll status confirmation, and equipment specifications for the project. The form includes a section for listing principal individuals assigned to the project with their positions and experience background, and requires documentation of financial responsibility either through direct financial institution information or a letter from the contractor's bank addressing account status and standing. All statements must be certified as complete and correct, with references authorized to verify the contractor's capability to perform the work.

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Text version

Sheet1

1. Contractors Name, Address, & Telephone No.:2. Type of Business
Name:
Address:Company
Corporation
Non-profit Org
Telephone No.:Co-partner
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 the projects your business has completed in the last 3 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 project:
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 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 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.
NAMETITLEDATE

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.

Sheet2

Sheet3

File details come from the government source that posted it. Updated .