Atch_4_Technical-Experience_Questionnaire.xls
XLS spreadsheet 31 KB Posted
- Attached to
- MEVE-ROMO REPLACE GAC FILTER MEDIA Federal contract opportunity
- Solicitation number
- 140P1226Q0044
About this file
This is a Technical/Experience Questionnaire form that contractors must complete to demonstrate their qualifications for the MEVE-ROMO Replace GAC Filter Media solicitation issued by the Department of the Interior National Park Service Intermountain Region (Solicitation Number 140P1226Q0044). The form requests comprehensive information about the contractor's background, capacity, and experience with Granulated Activated Carbon (GAC) Filter Media replacement services at Mesa Verde and Rocky Mountain National Parks.
The questionnaire requires contractors to provide their business information, including business type and SAM UEI number, along with their years of experience in this line of work and as a prime contractor. Contractors must list all Replacement of GAC Filter Media Service contracts completed within the last three years with contract amounts, project types, completion dates, and reference contacts. Additionally, contractors must disclose current contract commitments, including contract numbers, award amounts, completion status, and contact information. The form includes certification sections addressing whether the contractor has failed to complete awarded work or required performance bonds. Contractors must also provide details on organizational capacity, including minimum and maximum employee availability, payroll information, and equipment resources; identify principal individuals with relevant qualifications and certifications; and demonstrate financial responsibility through either financial institution references or a letter of financial standing. The completed form serves as a mechanism for the National Park Service to evaluate contractor capability and past performance before award.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Atch_2_As-Built_Drawings_GAC_Water_Plant_at_MEVE.pdf | ||
| Atch_1_Scope_of_Work_-_Replace_GAC_Filter_Media_at_MEVE.pdf | ||
| Atch_3_Scope_of_Work_-__Replace_GAC_Filter_Media_at_ROMO.pdf | ||
| Sol_140P1226Q0044.pdf | ||
| Atch_6_DOL_WD_2015-5435_Rev_30.pdf | ||
| Atch_5_Price_Schedule.docx | DOCX document | |
| Atch_7_DOL_WD_2015-5421_Rev_33.pdf |
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Text version
Sheet1
| TECHNICAL/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. | ||||||||
| 1. Contractors Name, Address, & Telephone No.: | 2. Type of Business | ||||||||
| Name: | |||||||||
| Address: | Company | ||||||||
| Corporation | |||||||||
| Non-profit Org | |||||||||
| Telephone No.: | Co-partner | ||||||||
| SAM UEI No: | 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 Replacement of GAC Filter Media Service contracts that were 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 service: | ||||||||||||||
| 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 with proper qualifications/certifications 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 I intend to complete the project as specified and that my offer conforms to the specifications of the solicitation without deviation unless I provide an alternative proposal. 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. | ||||||||||||||
| SIGNATURE | TITLE | DATE |
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