Attachment 3 - Pre-Award Survey.pdf
PDF 89 KB Posted
- Attached to
- Tooele Army Depot Gas Line and Fuel Swap
- Solicitation number
- W9123821R0047
About this file
This document contains a pre-award survey for a construction contractor and details of a related federal contract opportunity for gas line and fuel swap work at Tooele Army Depot in Utah. The pre-award survey requests information on the contractor's organization, personnel, equipment, financial data, experience on past construction projects, and type of work specialized in. The related federal contract opportunity is a lowest priced technically acceptable request for proposal from the Department of the Army Corps of Engineers to design and construct approximately 12 miles of new natural gas lines, upgrade fuel systems in 26 buildings to heat pumps, and perform other energy efficiency work at an estimated value between $5-10 million. The work is to expand natural gas infrastructure and reduce the use of fuel oil and propane at the depot.
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Text version
The Government will treat the pre-award survey information submitted by the offeror as proprietary.
CONSTRUCTION CONTRACTOR DATA DATE:
Firm Name and Telephone Number
Tel:
Main Office Address (Street, City, and State)
Branch Offices Services Rendered
Construction
Design
Consultant
Organization
Individual Joint Venture
Partnership Corporation
Date Organized Date Incorporated:
State:
Names of Officers and Other Key Personnel
I – PRESENT PAYROLL PERSONNEL (List Number of Each Category Below)
Partners:
Officers:
Other Key:
Remainder: Subtotal Permanent:
Maximum Personnel at Any Time:
Date:
Total:
II—EQUIPMENT OWNED III—FINANCIAL DATA AS OF
(DATE): Present Value ($)
Current Assets:
Acquisition Cost ($) Current Liabilities:
Net Worth:
IV—TOTAL VALUE OF CONSTRUCTION AND DEMOLITION WORK IN
PAST 6 YRS EXCLUSIVE OF JOINT VENTURE (LIST MOST RECENT
FIRST)
V—LARGEST JOB EVER
CONTRACTED
(If Other Than in Past Six Years)
$ LARGEST JOB IN PAST 6 YRS Contract Amount:
Date: Description:
Owner:
$ Contract Amount:
Date: Description:
Owner:
Avg. Annual Income
VI—TYPE OF WORK IN WHICH FIRM SPECIALIZES
NAME AND POSITION/TITLE OF PERSON SIGNING SIGNATURE
See attachment for explanations or detailed description of item(s) reported above.
CONSTRUCTION CONTRACTOR DATA – SCHEDULE A – EXISTING COMMITMENTS
List below the construction projects your firm currently has under way, including recent awards. Also list construction projects for which your firm is the apparent successful offeror/bidder, but for which a contract has not yet been awarded.
CONTRACT
NUMBER
AMOUNT
DESCRIPTION/
LOCATION
ORGANIZATION/
CONTACT PERSON/
PHONE NUMBER
PERCENT
COMPLETE
CONSTRUCTION CONTRACTOR DATA – SCHEDULE B – COMPLETED PROJECTS
List below the principal construction projects your firm has completed within the past five years, including all DoD contracts with a total value exceeding $500,000.00
NUMBER
AMOUNT
DESCRIPTION/
LOCATION
ORGANIZATION/
CONTACT PERSON/
PHONE NUMBER
PERCENT
SUBLET
CONSTRUCTION CONTRACTOR DATA – SCHEDULE C –
CONSTRUCTION AND/OR TECHNICAL EQUIPMENT
List total equipment and facilities owned for performing the prospective contract and present status as to whether or not it is currently committed to existing contracts.
QUANTITY
DESCRIPTION
CONDITION
YEARS OF
SERVICE
PRESENT
STATUS
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