Atch_5_Technical-Experience_Questionnaire.xlsx
XLSX spreadsheet 20 KB Posted
- Attached to
- CANY-ISKY-GRAND VIEW POINT VAULT TOILETS
- Solicitation number
- 140P1226Q0008
About this file
This is a Technical Experience Questionnaire template required for submission in response to the Canyonlands National Park vault toilet construction solicitation (140P1226Q0008). The form serves as an evaluation tool to assess contractor qualifications and capability to perform the work.
The questionnaire requires contractors to provide comprehensive information including: business type and registration details (SAM UEI Number); years of experience in vault toilet projects and as a prime contractor; documentation of vault toilet projects completed within the last three years with contract amounts, project types, completion dates, and reference contacts; current contract commitments with award amounts and completion percentages; performance history including any failures to complete work or instances requiring performance bonds; organizational capacity with minimum and maximum employee counts and equipment specifications; qualifications and experience of key personnel assigned to the project; and financial responsibility documentation from a lending institution or letter of financial standing. The form requires contractor certification that the bid conforms to solicitation specifications and authorizes the National Park Service to verify capability through named references. Contractors may complete the form manually or using Microsoft Excel, with additional space available in the remarks section for extended responses.
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Text version
Sheet1
| 1. Contractors Name, Address, & Telephone No.: | 2. Type of Business | ||
| Name: | |||
| Address: | Company | ||
| Corporation | |||
| Non-profit Org | |||
| Telephone No.: | Co-partner | ||
| SAM UEI Number: | 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 the Vault Toilet projects your business has 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 project: | ||||
| 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
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.
File details come from the government source that posted it. Updated .