Atch_4_Experience_Questionnaire.xls
XLS spreadsheet 31 KB Posted
- Solicitation number
- 140P6326Q0027
About this file
This is an Experience Questionnaire form designed to evaluate contractor capability and qualifications for federal projects administered by the National Park Service.
The form requires contractors to provide comprehensive background information including company name, address, and telephone number along with business type classification (corporation, non-profit, individual, or co-partner). Contractors must document relevant experience by specifying years in their line of work and years as a prime contractor, then list completed projects from the past three years with contract amounts, project types, completion dates, and reference contact information. The questionnaire also requests current contract commitments showing contract numbers, award amounts, completion percentages, and expected completion dates. Contractors must disclose any history of incomplete work or performance bonds and provide details on organizational capacity including minimum and maximum available employees, payroll status, and equipment resources. Additionally, contractors must list principal individuals assigned to the project with their positions, years of experience, and work types. Financial responsibility documentation is required, either through direct submission of account status information or a letter from the contractor's financial institution. The form includes certification language whereby contractors attest to the accuracy and completeness of all statements provided. This questionnaire is referenced as Attachment 4 for the Lincoln Home National Historic Site automatic glass door replacement project solicitation (140P6326Q0027) issued by the Department of the Interior National Park Service Midwest Region.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140P6326Q0027_Amd_0001.pdf | ||
| Amd_0001_Questions-Answers_0001.pdf | ||
| Atch_1_SOW.pdf | ||
| Atch_5_DOL_Wage_Determination_IL20260004_5_18_26.pdf | ||
| Atch_2_Appendix_E.pdf | ||
| Sol_140P6326Q0027.pdf | ||
| Atch_3_Price_Schedule.xlsx | XLSX spreadsheet |
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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 | |||||||
| 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 |
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 .