Attachment 5 - Firm and Project Information.pdf
PDF 158 KB Posted
- Attached to
- OIJ Shooting Range Construction, Costa Rica
- Solicitation number
- 19AQMM23R0072
About this file
This document contains a questionnaire for firms to provide information on a project for the construction of a shooting range in Costa Rica. The questionnaire requests details on the firm such as name, address, phone numbers, owners and key personnel. It also asks for information on any subcontractors or suppliers to be used for more than 10% of the project, and whether the firm meets local licensing and insurance requirements. The firm must certify the accuracy of the information and sign and date the document.
The related federal contract opportunity is solicitation number 19AQMM23R0072 for the construction of an OIJ shooting range in Costa Rica from the Department of State Office of Acquisition Management. No other details are provided on requirements, response dates, or award timing.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 19AQMM23R0072 0001.zip | ZIP file | |
| 19AQMM23R0072.pdf | ||
| Attachment 3 - Technical Specs.pdf | ||
| Attachment 4 - Drawings.zip | ZIP file | |
| Attachment 2 - Bid Chart.xls | XLS spreadsheet | |
| Attachment 1 - OIJ Shooting Range SOW.pdf | ||
| 19AQMM23R0072 B-M.pdf | ||
| Attachment 6 - Past Performance Questionnaire (PPQ).docx | DOCX document |
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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 .