Attachment 5 - Pre-Award Survey.pdf

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Attached to
Natomas Reach D Pumping Plant 4 Federal contract opportunity
Solicitation number
W9123821B0002
Issued by
Department of the Army Corps of Engineers Engineering District Sacramento

About this file

This pre-award survey form requests information from offerors on a construction contract opportunity with the U.S. Army Corps of Engineers for the Natomas Reach D Pumping Plant 4 project. The scope of work includes relocating and raising discharge pipes, adding a new vault and outfall structure, removing existing buildings and installing a new trash rack, raising the pump station pad and installing new pumps without a new building, and constructing fencing and site access improvements. Offerors are asked to provide details on their organization structure and ownership, current and past project experience including values and descriptions, equipment owned, and existing project commitments. Required response information includes personnel counts, financial data, references for the largest past projects, specializations, and schedules listing current projects, completed work from the past five years, and owned construction equipment.

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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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