Attachment_4_140P8426Q0064_Tech_Info_Form_with_License_and_Safety.docx
DOCX document 28 KB Posted
- Attached to
- Replace Roof at Maintenance & Admin Bldg LEWI
- Solicitation number
- 140P8326Q0064
About this file
This is a Technical Information Form that quoters must complete and submit as part of RFQ No. 140P8426Q0064 for roof replacement work at the Maintenance Building and Administrative Building at Lewis and Clark National Historical Park under the Department of the Interior National Park Service Pacific West Region.
Quoters must provide their business information, including name, address, UEI, phone number, and contact details, along with a signature. The form requires disclosure of proposed team structure, specifically whether the quoter will self-perform all work or utilize subcontractors, with identification of subcontractor names and assigned trades. Quoters must describe any work activities they plan to self-perform. The form mandates submission of at least three relevant past performance projects with contract numbers, agency/owner information, dollar amounts, performance periods, project descriptions demonstrating similarity to the current requirement, and references with contact information. Quoters must confirm Oregon contractor licensing status for both prime contractors and any proposed subcontractors, including license details and numbers. Additionally, quoters must submit their company's general Construction Safety Program overview, provide a narrative assessment of safety risks specific to this roofing project and any required modifications to their safety program, and include OSHA 300A logs for the previous three calendar years for both the prime contractor and any proposed subcontractors. This template establishes the minimum documentation and qualifications required for submission of quotes in response to this federal roofing project solicitation.
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Text version
RFQ No. 140P8426Q0047, Attachment 3, Technical Information Form
TECHNICAL INFORMATION FORM
(Attachment 4)
Maintenance Building and Administrative Building Roof Replacement Lewis and Clark National Historical Park RFQ No.: 140P8426Q0064
Quoters shall submit the following information:
Quoters Business Name: ___________________________________
Quoters Address: ___________________________________
Quoters UEI: ___________________________________
Quoters Phone: ___________________________________
Quoters Contact Name: ___________________________________
Quoters Signature: ___________________________________
CONTRACTOR’S PROPOSED TEAM:
Do you plan to self-perform all of the work? ___________________________ YES or NO answer
Are you proposing to use a subcontractor? ___________________________ YES or NO answer
List any proposed subcontractor(s) and indicate what key trade they may be assigned to perform:
| Subcontractor Name |
| Key Trade (Roofing, etc.) |
If you are proposing to use a subcontractor, describe what work activities you plan to self-perform:
LIST OF RELEVANT EXPERIENCE (LIST OF PROJECTS) & PAST PERFORMANCE REFERENCES:
1) Project Title: ___________________________ Contract # (if known): ______________
Agency/Owner: ___________________________ $ Amount: _______________________
Performance Period: ___________________________
Briefly describe how this project is similar in nature and scope to current advertised requirement:
Past Performance Reference (Name & Title): _______________________________________________
Phone Number: ___________________________ Email: __________________________
2) Project Title: ___________________________ Contract # (if known): ______________
Agency/Owner: ___________________________ $ Amount: _______________________
Performance Period: ___________________________
Briefly describe how this project is similar in nature and scope to current advertised requirement:
Past Performance Reference (Name & Title): _______________________________________________
Phone Number: ___________________________ Email: __________________________
3) Project Title: ___________________________ Contract # (if known): ______________
Agency/Owner: ___________________________ $ Amount: _______________________
Performance Period: ___________________________
Briefly describe how this project is similar in nature and scope to current advertised requirement:
Past Performance Reference (Name & Title): _______________________________________________
Phone Number: ___________________________ Email: __________________________
OREGON CONTRACTOR STATE LICENSE:
Is your firm a OR Licensed Contractor, such as “A” General ___________________________ Engineering Contractor or “B” General Building Contractor? YES or NO answer
☐ license details/number: ______________________ ☐ proof of license is searchable online or include with your quote
IF you are proposing to use a subcontractor for any of the work:
Is subcontractor a OR Licensed Contractor, such as “A” General ___________________________ Engineering Contractor or other classification that is applicable YES or NO answer to their work?
☐ license details/number: ______________________ ☐ proof of license is searchable online or include with your quote
SAFETY RECORD:
☐ Submit an overview of your company’s general Construction Safety Program – attach with your quote
NARRATIVE – in the space below briefly provide an assessment of the safety risks associated with this construction project, and discuss any changes to your company’s Construction Safety Program required to address your assessment of the project risk:
☐ Submit a copy of your company’s OSHA 300A logs for the previous three calendar years.
☐ If proposing to use a subcontractor for any of the work, additionally submit a copy of your proposed subcontractor’s OSHA 300A logs for the previous three calendar years.
File details come from the government source that posted it. Updated .