Atch_4_Technical-Experience_Questionnaire.xls
XLS spreadsheet 31 KB Posted
- Attached to
- BRCA SOLID WASTE DISPOSAL Federal contract opportunity
- Solicitation number
- 140P1226Q0042
About this file
This is a Technical/Experience Questionnaire form designed to evaluate contractor qualifications for the Bryce Canyon National Park Solid Waste Removal Service contract (Solicitation Number 140P1226Q0042) administered by the Department of the Interior National Park Service Intermountain Region.
The questionnaire requires contractors to provide comprehensive information about their business background, relevant experience, and operational capacity. Respondents must document their years of experience in solid waste removal services, including their history as prime contractors and a list of similar contracts completed within the last three years with associated project details. The form also requests current contract commitments with award amounts and completion percentages. Contractors must disclose any history of incomplete work or performance bonds and identify their available workforce, specifying minimum and maximum employee numbers, payroll status, and equipment resources dedicated to the project. Additionally, the form requires identification of principal individuals assigned to the project with their qualifications, certifications, and relevant experience, along with financial responsibility documentation from a financial institution or equivalent letter. The questionnaire includes a certification statement requiring the contractor to affirm that they will complete the project as specified and that all provided information is accurate and complete to the best of their knowledge.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Atch_1_SOW_BRCA_Refuse_Collection_and_Disposal.docx | DOCX document | |
| Atch_2_SOW_Dumpster_Locations.docx | DOCX document | |
| Sol_140P1226Q0042.pdf | ||
| Atch_3_Price_Schedule.xlsx | XLSX spreadsheet | |
| Atch_5_DOL_WD_2015-5495_Rev_29.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 Solid Waste Removal 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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Sheet3
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