ATTACH_9_-_QUALIFICATIONS_STATEMENT.pdf
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- Solicitation number
- 140S0323B0003
About this file
This document contains a Contractor's Qualifications Statement template to be submitted in response to Solicitation Number 140S0323B0003 from the Department of the Interior Office of Surface Mining Reclamation and Enforcement. The template requires contact information and details on the contractor's equipment, experience on similar past projects including names of owners and engineers, proposed superintendent's background, any planned subcontractors and their relevant experience, bonding and insurance information as applicable, and a list of principals involved in the bid. Contractors must complete and submit this statement with their offer to enable the agency to evaluate responsibility for a potential contract award for Project WA-22-004 concerning electric and coal mines.
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CONTRACTOR'S QUALIFICATIONS STATEMENT
Complete in full and submit with your offer. Failure to submit this information will not be cause for rejection of your offer. However, if your firm is in line for a contract award, this information will be requested and is required to enable this office to make a determination of responsibility to consummate the award process. Use additional sheets if needed.
1. Name and Permanent Place of Business:
Name:
Address:
City: State: Zip:
Phone No: Duns No:
2. Equipment
List all equipment to be utilized in performing work covered by the solicitation. Contractor must show evidence of firm commitment in writing for equipment not owned by contractor.
Type of Model/ Size/ Age/ Lien Equipment Manufacturer Capacity Condition Holder
3. Contractor's Experience
List and describe experience with previous and current work similar to this project.
Project Name: Owner's Name:
Project Location: Owner's Address:
Owner's Engineer in Charge:
Phone No: Date of Work: Cost:
Description of Work:
Owner's Engineer in Charge:
Owner's Engineer in Charge:
Owner's Engineer in Charge:
4. Offeror's Proposed Superintendent and Experience
Name: Work Phone:
Address: Home Phone:
List and describe superintendent's experience with work similar to this project. The on-site superintendent is required to have experience supervising earthwork and concrete construction.
Owner's Engineer in Charge:
Owner's Engineer in Charge:
Owner's Engineer in Charge:
5. Subcontractors
Offeror proposes to use the following subcontractors for the noted items of work.
Subcontractor Name & Address Description of Proposed Work
6. Subcontractor's Experience in Work Comparable to Proposed Work
Subcontractor's Name:
Project Location: Owner's Address:
Owner's Engineer in Charge:
Project Location: Owner's Address:
Owner's Engineer in Charge:
Project Location: Owner's Address:
Owner's Engineer in Charge:
7. Bonding (when applicable)
Offeror proposes to obtain a Payment Guarantee with the following corporate surety and agent within the time specified in this Invitation for Bid.
Surety
Agency
Address
8. Principals
List full names and permanent addresses of persons and firms involved in the attached offer as principals.
Name: Title:
Name: Title:
9. List all outstanding court judgments, mechanics liens, and other civil or criminal actions pending against offeror or principals.
Signature:
Name (printed):
Title: Date:
File details come from the government source that posted it. Updated .