Atch_3_Technical-Experience_Questionaire.xls
XLS spreadsheet 31 KB Posted
- Solicitation number
- 140P1225Q0082
About this file
This document is a Technical and Experience Questionnaire for a federal contract opportunity related to HVAC pump and boiler replacement at Pecos National Historical Park. The questionnaire requires detailed information from potential contractors, including business type, years of experience in heating pump replacements, past project history, current contract commitments, employee resources, key personnel qualifications, and financial responsibility.
The form seeks comprehensive documentation of a contractor's capability to perform the project, with sections covering project experience (specifically heating system pump replacements within the last 5 years), organizational capacity (minimum and maximum employee availability), equipment resources, key personnel experience, and financial standing. Contractors must provide verifiable references, detail their project history, and certify the accuracy of their submitted information. The solicitation is issued by the Department of the Interior National Park Service Intermountain Region, with the specific opportunity (Solicitation Number 140P1225Q0082) focused on replacing HVAC pumps and boilers at the Kozlowski Trading Post within Pecos National Historical Park.
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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 of experience doing heating pump replacements? | Years | ||||||
| 5. List the projects your business has completed with replacement of heating system pumps within the last 5 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 project: | ||||||||||||||
| 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 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 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. | ||||||||||||||
| NAME | TITLE | DATE |
TECHNICAL AND 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.
File details come from the government source that posted it. Updated .