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
Issued by
Department of the Interior National Park Service Intermountain Region

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.

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Other files for this federal contract opportunity

Other files attached to MEVE-ROMO REPLACE GAC FILTER MEDIA, newest first.
File Type Posted
Atch_2_As-Built_Drawings_GAC_Water_Plant_at_MEVE.pdf PDF
Atch_1_Scope_of_Work_-_Replace_GAC_Filter_Media_at_MEVE.pdf PDF
Atch_3_Scope_of_Work_-__Replace_GAC_Filter_Media_at_ROMO.pdf PDF
Sol_140P1226Q0044.pdf PDF
Atch_6_DOL_WD_2015-5435_Rev_30.pdf PDF
Atch_5_Price_Schedule.docx DOCX document
Atch_7_DOL_WD_2015-5421_Rev_33.pdf PDF

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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
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 service:
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 with proper qualifications/certifications 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 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.
SIGNATURETITLEDATE

Sheet2

Sheet3

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