Attachment 4 - Firm and Project Information.pdf
PDF 158 KB Posted
- Attached to
- AERONet Communication Tower
- Solicitation number
- 19AQMM24R0037
About this file
This document contains a Firm and Project Information Questionnaire to be completed by offerors for federal contract number 19AQMM24R0037. The solicitation is for the construction of an Aeronet Communication Tower issued by the Department of State Office of Acquisition Management. The questionnaire requests information on the offeror's firm including ownership, licenses, permits, insurance, and bonding qualifications. It also requests details on any planned subcontractors or suppliers to be used, including their scope of work or materials provided and respective percentages of the total project value. Offerors must certify that the information provided is accurate and verifiable.
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Text version
Firm and Project Information Questionnaire
Firm Information NIT NUMBER:
NAME ADDRESS TELEPHONE/FAX
Owners, Partners and Principal Officer
NAME POSITION TELEPHONE
Legal Representatives and backups
NAME POSITION TELEPHONE
Project Director, Superintendent and key technical Personnel for this project
NAME POSITION TELEPHONE
Subcontractors for this project (if it does not apply indicate it in the chart)
NAME ACTIVITY TO PERFORM
% DEL PROJECT
TOTAL
TELEPHONE
Suppliers for this project
NAME MATERIALS TO SUPPLY
% DEL PROJECT
TOTAL
TELEPHONE
Requirements of the Offeror and Owners/partners:
DESCRIPTION YES NO NOTES
I certify that the information is accurate and verifiable
Signature of the Legal Representative Date
Name of the Legal Representative Id Number
ENGLISH COMMUNICATION
(Ability to understand, write and read)
ADDRESS AND CITY
Artículo 289 del Código Penal Colombiano: “El que falsifique documento privado que pueda servir de prueba, incurrirá, si lo usa, en prisión de uno (1) a seis (6) años .”
"FIRM AND PROJECT INFORMATION "
E-MAIL ADDRESS
ENGLISH COMMUNICATION
(Ability to understand, write and read)
Has adverse criminal record?
Has political or business affiliation which could be considered contrary to the interests of the United
States.
ADDRESS AND CITY
ENGLISH COMMUNICATION
(Ability to understand, write and read)
Has all licenses and permits required by local law to perform?(Chamber of Commerce, Merchandise
Register, Professional Licenses, etc.)
Meets local insurance requirements (Prestaciones Sociales, ICA, Sena, etc.)
Has the ability to obtain a performance and guarantee bond and payment bond, or adequate performance security, such as irrevocable letters of credit or guarantees issued by a reputable financial institution. Include Information
File details come from the government source that posted it. Updated .