Attachment 5 - Technical Proposal Questionnaire Form.docx
DOCX document 29 KB Posted
- Attached to
- GAOA Hapgood Fishing Pier & Trailer Step Replacement Construction, Green Mtn National Forest, Vermont
- Solicitation number
- 12445524Q0087
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a Technical Proposal Questionnaire form related to RFQ #12445524Q0087 for the Hapgood Fishing Pier & Trail Construction Project in the Green Mountain National Forest, Vermont. The form instructs the offeror to provide information on their general experience, resources, and logistics for completing this construction project. Key details requested include the offeror's business structure, relevant project experience, available employees and equipment, and a narrative on their experience with similar work. The offeror must also certify the accuracy of the information provided. The RFQ is a 100% Small Business Set-Aside procurement, with the Price and Technical Proposal due by 1700 EST on 10 July 2024. The contract will be awarded by the USDA Forest Service.
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Text version
OFFEROR RESPONSE TO FACTORS 1 and 2 RFQ #12445524Q0087 Hapgood Fishing Pier & Trail Construction Project OFFEROR RESPONSE TO FACTORS 1 and 2 RFQ #12445524Q0087 Hapgood Fishing Pier & Trail Construction Project
USDA Forest Service
TECHNICAL PROPOSAL QUESTIONNAIRE
Instructions: Factor 1 – General Experience: Complete Blocks 1 through 8 and Factor 2 – Resources & Logistics: Complete Blocks 9 through 11. If additional space is needed for supporting information, use the space on Page 3 of this Questionnaire and provide the associated Block Number the information is referring to.
1. Contractor Name, Address, Telephone Number and UEI Number and SAM Registration Expiration Date
2. Submitted to (Office Name and Address)
3. Business [ ] Company [ ] Co-partnership [ ] Corporation [ ] Individual
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years experience have you had as a (a) prime contractor ______ and/or (b) sub-contractor ______?
6. List below the projects your business has completed within the last three (3) years:
| Total Value |
| Description or Title of Project |
| Date Completed |
| Name, & Telephone No. of |
Owner/Person to Contact for Project Information
7. List below your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
| Contract, Task Order or Purchase Order Number |
| Dollar Amt. of Award |
| Name, Address, and Telephone No. of Business Owner or Government Agency Involved |
| Subcontractor or Prime Contractor |
| Percent Completed |
| Date Completed |
8a. Have you ever failed to complete any work awarded to you? [ ] Yes [ ] No 8b. Has work ever been completed by performance bond? [ ] Yes [ ] No 8c. Has contracted work ever been terminated for default? [ ] Yes [ ] No 8d. If “Yes” to either item 8a.,8b., or 8c., specify location(s) and reason(s) why and circumstances:
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (2) Maximum number of employees: _____
b. Are employees regularly on your payroll: [ ] Yes [ ] No
c. Specify equipment available for this contract:______________________________________________________
| Work Item | |
| Description | |
| Estimated |
No. of Days to Complete Estimated Hrs of Onsite Work Per Day Starting Time and End Time
| 01 |
| Mobilization at Fishing Pier and Stone Steps |
| 02 |
| Construction Survey and Staking, Method 1, Tolerance B |
| 03 |
| Soil Erosion and Pollution Control |
| 04 |
| Removal of Structures and Obstructions |
| 05 |
| Bedding Material |
| 06 |
| Placed Riprap – Class 2 |
| 07 |
| Helical Pier, Furnished and Installed |
| 08 |
| Treated Structural Timber and Lumber |
| 09 |
| Bench |
| 10 |
| Composite Decking 2X6 |
| 11 |
| Government Furnished Color Blind Telescope Viewer |
| 12 |
| Overlapping Stone Steps |
| 13 |
| Trail Surface Aggregate |
| 14 |
| Railing System (Option Item) |
d. Estimate progress rates for work items of this project:
TECHNICAL PROPOSAL QUESTIONNAIRE – PAGE 2
10. List below the experience of the principal individuals of your business: (Who will directly be involved in this Purchase Order?)
| Individual’s Name |
| Present Position |
| Years of Experience |
| Magnitude and Type of Work |
11. Provide narrative detailing experience the offeror has, either as a Prime Contractor (GC) or as a Subcontractor, of work similar in nature and scope to geographical conditions similar to this requirement (for example, remote location; damp climate; similar logistical challenges for transporting equipment and material, etc.). You may use Page 4 of this Form, or additional sheets, as necessary, to address Block 11 of this Questionnaire.
TECHNICAL PROPOSAL QUESTIONNAIRE – PAGE 3
NOTE: PLEASE PROVIDE BELOW ANY ADDITIONAL INFORMATION TO SUPPORT BLOCKS 1 THROUGH 11 OF THIS FORM THAT WILL HELP DETERMINE YOUR ABILITY TO SUCCESSFULLY COMPLETE THIS PROJECT.
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge, and that any persons named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
12a. CERTIFYING OFFICIAL’S NAME OF OFFEROR AND TITLE
| b. SIGNATURE (Sign in ink) |
| 13. DATE |
TECHNICAL PROPOSAL QUESTIONNAIRE – PAGE 4
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