Atch 4 ResQuestionnaire.docx
DOCX document 28 KB Posted
- Attached to
- Building 305 Office Renovations - ZQEL 19-0016
- Solicitation number
- FA665626B0002
About this file
This file is a questionnaire attachment related to a Building 305 Office Renovations solicitation at Youngstown Air Reserve Station. The questionnaire serves as a template for prospective offerors to provide information about their qualifications, experience, and capability to perform the renovation work outlined in solicitation FA665626B0002 (ZQEL 19-0016).
The renovation project involves remodeling the Commander's Suite area and adjacent hallway in Building 305, an Aircraft Maintenance Hanger, with an estimated project cost between $100,000 and $250,000. Key scope items include removing and installing walls, removing electrical fixtures and relocating them to new walls, removing and replacing carpeting, painting all walls, installing new vinyl base cove trim, replacing doors with solid cherry finish, installing picture windows, and rerouting existing duct work. This is a 100% HUBZone Small Business Set-Aside requiring HUBZone certification at time of award, and the contracting vehicle is a Firm-Fixed Price award. The issuing agency is the 910th Airlift Wing (AFRC) at Youngstown Air Reserve Station, Ohio, under NAICS Code 236220 (Commercial and Institutional Building Construction). A mandatory site visit was scheduled for June 22, 2026, at 10:00 AM EDT for all prospective offerors to inspect the project site and existing conditions.
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ATTACHMENT 4
RESPONSIBILITY QUESTIONAIRE
The following information is needed to help evaluate and determine your company responsible. Please complete the following items and submit with your proposal:
A. The names of at least three (3) suppliers that you do business with, to include points of contact and phone numbers.
I. Name of Supplier: _____________________________________________________
Address: ______________________________________________________________
Name of POC: _________________________________________________________
Telephone No: _________________________________________________________
II. Name of Supplier: ____________________________________________________
Address: ______________________________________________________________
Telephone No: _________________________________________________________
III. Name of Supplier: ___________________________________________________
Address: ______________________________________________________________
Telephone No: ________________________________________________
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your proposal a reference sheet for each financial institution that you have a business account with. This sheet may be sent to the banking institution/s in regards to a determination of contractor responsibility as part of the evaluation for award of this solicitation.
TO BE FILLED OUT BY CONTRACTOR:
COMPANY’S NAME: ____________________________________________________________
Point of Contact (POC) Name: _______________________________________________ POC Phone Number: __________________________________________________________ Email: __________________________________________________________
INSTITUTION NAME: __________________________________________________________
POC name: __________________________________________________________________ POC title: _________________________________________________________________ POC phone number: ______________________ fax number: _______________________ Email: __________________________________________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 910th Contracting Squadron, Youngstown ARS, Vienna OH.
| _____________________________________ | ________________________________ | |
| Name/Title | Signature/Date |
DO NOT HAVE THIS SECTION FILLED OUT. IF YOUR FIRM IS SELECTED AS THE POTENTIAL AWARDEE, THIS FORM WILL BE SENT TO YOUR BANKING INSTITUTION FOR COMPLETION.
TO BE FILLED OUT BY FINANCIAL INSTITUTION:
Please give amounts as a range – i.e. low four figures, mid six figures, etc.
Average monthly balance in checking: ________________ Average monthly balance in savings: _________________ Amount of any current loans: ______________ Amount of any lines of credit: ______________ Any late payments or NSF’s? ______________ How long with this institution: ______________ Credit rating with this institution: ______________
I verify that the information provided above is current as of ____________.
| _____________________________________ | ________________________________ | |
| Name/Title | Signature/Date |
LIST OF EQUIPMENT DEDICATED TO PROJECT
(Owned/Rented)
1.
2.
3.
4.
5.
Attachment 4
File details come from the government source that posted it. Updated .