Attachment A.pdf

PDF 132 KB Posted

Attached to
Indiana Shoreline Erosion Project: Beach Nourishment Services
Solicitation number
W912P622B0014
Issued by

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Other files

File Type Posted
Bid Opening Results.docx DOCX document
W912P622B0014-0002.pdf PDF
Attachment I (For AMDT 0002).pdf PDF
Attachment B (For AMDT 0002).pdf PDF
Attachment H (For AMDT 0002).pdf PDF
Attachment F (For AMDT 0001).pdf PDF
Attachment G (For AMDT 0001).pdf PDF
Attachment C (For AMDT 0001).pdf PDF
Attachment E.pdf PDF
W912P622B0014-0001.pdf PDF
Attachment B (For AMDT 0001) Performance of Work Statement.pdf PDF
Attachment C.pdf PDF
Attachment B.pdf PDF
Attachment E.pdf PDF
Attachment D.pdf PDF
W912P622B0014 - 16SEPT22.pdf PDF
Attachment F.pdf PDF
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ATTACHMENT A

PREAWARD SURVEY INFORMATION

(RE: Subparts 9.104-1 and 9.105-1 of the Federal Acquisition Regulation)

CONTRACTOR: ____________________________________________

SOLICITATION: W912P622B0014, INDIANA SHORELINE EROSION PROJECT – Beach Nourishment Services

Please complete the below form to assist in the completion of a Pre-award Survey:

1. Month and Year started in business: ____________________________________________

2. Year and State Incorporated: ____________________________________________

3. Key Personnel:

President/Owner: ____________________________________________

Vice President/Partner: ____________________________________________

Secretary/Treasurer: ____________________________________________

4. Number of Full-Time Employees: ____________________________________________

5. Surety:

Agency: ____________________________________________

Agent: ____________________________________________

Address, City & State: ____________________________________________

Telephone#: ____________________________________________

6. Insurance Company:

Agency: ____________________________________________

Agent: ____________________________________________

Address, City & State: ____________________________________________

Telephone#: ____________________________________________

7. Financial Institution Information:

Name of Bank: ____________________________________________

Contact Person: ____________________________________________

Address, City & State: ____________________________________________

Telephone#: ____________________________________________

8. References: Provide the names and contact information of three references. Information obtained from references will be used to determine if you have been diligent in the following areas: a) Quality of Work; b) Timely Performance; c) Effectiveness of Management; d) Compliance with Safety Standards; and e) Compliance with Labor Standards.

9. Does your company have any ongoing projects that may cause a problem with completing or beginning performance of the subject project?

10. Does your company own all of necessary tools and equipment to perform the work of the project?

END OF FORM

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