B08_Attachment_04_140P8422Q0091_Tech_Info_Form.pdf

TECHNICAL INFORMATION FORM

(Attachment 4)

Repair Leaking Historic Redwood Tanks on Anacapa Island Channel Islands National Park

RFQ No.: 140P8422Q0091

Quoters shall submit the following information:

Quoters Business Name: ___________________________________

Quoters Address: ___________________________________

Quoters UEI: ___________________________________

Quoters Phone: ___________________________________

Quoters Contact Name: ___________________________________

Quoters Signature: ___________________________________

CONTRACTOR’S PROPOSED TEAM:

Do you plan to self-perform all of the work? ___________________________

YES or NO answer

Are you proposing to use a subcontractor? ___________________________ YES or NO answer

List any proposed subcontractor(s) and indicate what key trade they may be assigned to perform:

Subcontractor Name Key Trade (Roofing, etc.)

If you are proposing to use a subcontractor, describe what work activities you plan to self-perform:

RFQ No. 140P8422Q0091, Attachment 4, Technical Information Form

REQUIRED QUALIFICATION:

Is your firm a CA Licensed “A” (General Engineering Contractor) or _________________________ “B” (General Building Contractor) YES or NO answer

☐ proof of CA license is required – include with your quote

IF you are proposing to use a subcontractor:

☐ proof of proposed sub’s applicable CA license is required – include with your quote

☐ proof of prime contractor’s CA Contractor State License classification such as “A” (General Engineering Contractor) or “B” General Building Contractor is required – include with your quote

RFQ No. 140P8422Q0091, Attachment 4, Technical Information Form

LIST OF RELEVANT EXPERIENCE (LIST OF PROJECTS) & PAST PERFORMANCE REFERENCES:

1) Project Title: ___________________________ Contract # (if known): ______________

Agency/Owner: ___________________________ $ Amount: _______________________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title): _______________________________________________

Phone Number: ___________________________ Email: __________________________

2) Project Title: ___________________________ Contract # (if known): ______________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement:

3) Project Title: ___________________________ Contract # (if known): ______________

Performance Period: ___________________________

Briefly describe how this project is similar in nature and scope to current advertised requirement: