Att 04_140P8419Q0069_Technical Info Form.pdf

TECHNICAL INFORMATION FORM

Water Testing of Park Water Systems Point Reyes National Seashore

RFQ No.: 140P8420Q0069

Offerors shall submit the following information:

Offerors Business Name: _________________________

Offerors Address: _________________________

Offerors DUNS: _________________________

Offerors Phone: _________________________

Offerors Name: _________________________

Offerors Signature: __________________________

CONFIRMATION OF STANDARDS AND REQUIREMENTS:

Is your Lab ELAP certified by the State of California? _________________________ (proof required – please attach and include with your quote) YES or NO answer

Will your Lab provide all sampling bottles required for needed testing? ________________________ YES or NO answer

Is your Lab available to run and read tests during the weekend in the ________________________ event of a weekend emergency? YES or NO answer

PAST PERFORMANCE REFERENCES:

Name: ___________________________ Name:____________________________

Business: ___________________________ Business:__________________________

Address: ___________________________ Address:___________________________

Phone Number: ___________________________ Phone Number:_____________________

Name: ___________________________

Business: ___________________________

Address: ___________________________

Phone Number: ___________________________

RFQ No. 140P8419Q0069, Attachment 04, Technical Information Form

LIST OF RELEVANT PROJECTS:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Contract # (if known): ___________________________

Agency/Owner: ___________________________

Contact Person: ___________________________

Phone Number: ___________________________

Amount: ___________________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement: