Attachment 5 Pre-Award Survey Form.doc

PRE-AWARD SURVEY INFORMATION

The Government reserves the right, prior to making an award, to conduct a pre-award survey of the prospective contractors in order to determine that the contractors can meet the minimum standards for responsible contractors as defined in Federal Acquisition Regulation (FAR) 9.106. The pre-award survey may include, but will not necessarily be limited to the following factors:

(1) Financial Resources such as sufficient working capital to permit performance under the contract for a period of sixty (60) days after the effective date of the contract before reimbursement by the Government;

(2) Ability to comply with required schedules;

(3) Past record of integrity;

(4) Past record of performance; and

(5) Ability to meet other qualifications and eligibility requirement to receive an award of a contract.

(6) An on-site inspection may be conducted of the facility of the apparent successful bidder (s) offeror(s) prior to contract award for specifications compliance.

A Pre-Award survey may be conducted in order to determine contractor responsibility. Please provide at least one (1) and up to three (3) performance references, for work the same as or similar to the work set forth in this solicitation, and one (1) financial reference in the spaces provided below. The performance references can consist of companies for which you have recently performed work. References must be of comparable magnitude and similar in nature to the work required under this solicitation. The financial reference should be your financial institution.

Three Performance References:

Name:

Address:

Phone:

Email:

Contract Number:

Amount:

Description:

Name:

Address:

Phone:

Email:

Contract Number:

Amount:

Description:

Name:

Address:

Phone:

Email:

Contract Number:

Amount:

Description:

Financial Reference: (Please ensure your Financial Reference is aware that the Government may reach out to them) Name:

POC:

Address:

Phone:

Email

Description: