Atch_4_Experience_Questionnaire.xls

XLS spreadsheet 31 KB Posted

Attached to
Lincoln Home National Historic Site-Replace Automa
Solicitation number
140P6326Q0027
Issued by

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 PDF
Amd_0001_Questions-Answers_0001.pdf PDF
Atch_1_SOW.pdf PDF
Atch_5_DOL_Wage_Determination_IL20260004_5_18_26.pdf PDF
Atch_2_Appendix_E.pdf PDF
Sol_140P6326Q0027.pdf 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
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 .