ATCH_4_Instructor_Qualificaton_Checklist.pdf

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Attached to
Highway Drug Investigations for Patrol Course
Solicitation number
W912LP-21-R-0009
Issued by

About this file

This solicitation requests technical instruction services for a "Highway Drug Investigations for Patrol" course. The contractor shall provide the course in accordance with the attached performance work statement. Services are requested under several contract line item numbers for a base year and four option years. Proposal prices for all contract line items shall be firm fixed price and inclusive of all required labor, materials, travel, supervision and associated services. Proposals are due by 11:00 a.m. local time on September 10, 2021 to the USPFO for Iowa Purchasing and Contracting office. This is a 100% small business set-aside solicitation issued by the Department of the Army Iowa Army National Guard.

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INSTRUCTOR QUALIFICATION CHECKLIST

Solicitation #: Course Title:

Proposed Instructor Name:

INSTRUCTIONS

The Contract Specialist will enter the Performance Work Statement (PWS) paragraph number and corresponding qualification criteria in the blocks provided.

The Instructor shall select the appropriate response from the drop down in the “Meets Requirements” column. The instructor shall also provide a narrative of how he/she meets the qualification criteria, and the date range of the described qualification. If additional space is needed for any qualification, use the Qualification Narrative Continuation Page or add a blank page. Indicate the PWS paragraph number on each narrative that is being continued.

**A separate Instructor Qualification Checklist shall be completed by EACH instructor identified in the proposal.**

ATCH 2

52.212-2 Addendum

Para. #:

Qualification Meets

Requirement Date Range

From To

Instructor Narrative

Instructor Narrative

Instructor Narrative

Instructor Narrative

Instructor Narrative

Attachment #4

Qualification Narrative Continuation Page

PWS Paragraph Number:

Narrative:

Instructor certification. I hereby certify that the qualifications entered above are true and accurate to the best of my knowledge and belief.

Instructor’s Printed Name Instructor’s Signature Date

Verification. I have validated that the above-named instructor possesses the experience stated above.

Validating Official’s Printed Name & Title

Validating Officials’ Signature Date

Attachment #4

PWS ParagraphRow1:
QualificationRow1:
Instructor Narrative_2:
Instructor Narrative_3:
Instructor Narrative_4:
Instructor Narrative_5:
PWS Paragraph Number Narrative:
PWS Paragraph Number Narrative_2:
PWS Paragraph Number Narrative_3:
Dropdown2: [Choose One]
Date4_af_date:
Date5_af_date:
Dropdown8: [Choose One]
PWS Paragraph Number:
Instructor Narrative:
Dropdown10: [Choose One]
Date11_af_date:
Date12_af_date:
Date13_af_date:
Date14_af_date:
Dropdown16: [Choose One]
Date17_af_date:
Date18_af_date:
Dropdown20: [Choose One]
Date21_af_date:
Date22_af_date:
Instructor's Printed Name:
Date28_af_date:
Validating Official's Printed Name:
Date31_af_date:
Solicitation Number: W912LP-21-R-0009
Course Title: Highway Drug Investigations for Patrol
Proposed Instructor Name:
PWS ParagraphRow2:
PWS ParagraphRow3:
PWS ParagraphRow4:
PWS ParagraphRow5:
QualificationRow2:
QualificationRow3:
QualificationRow4:
QualificationRow5:
PWS ParagraphRow6:
PWS ParagraphRow7:

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