B08_Attachment_10_140P8423Q0047_Tech_Info_Form.docx

RFQ No. 140P8423Q0047, Attachment 10, Technical Information Form

TECHNICAL INFORMATION FORM

(Attachment 10)

Replace Barricade Gates Pinnacles National Park RFQ No.: 140P8423Q0047

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:

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

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): ______________

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: __________________________

3) 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: __________________________

CALIFORNIA CONTRACTOR STATE LICENSE:

☐ license details/number: ______________________ ☐ proof of license is searchable online or include with your quote

IF you are proposing to use a subcontractor for any of the work:

Is subcontractor a CA Licensed Contractor, such as “A” General ___________________________ Engineering Contractor or other classification that is applicable YES or NO answer to their work?

☐ license details/number: ______________________ ☐ proof of license is searchable online or include with your quote

SAFETY RECORD:

☐ Submit an overview of your company’s general Construction Safety Program – attach with your quote

NARRATIVE – in the space below briefly provide an assessment of the safety risks associated with this construction project, and discuss any changes to your company’s Construction Safety Program required to address your assessment of the project risk:

☐ Submit a copy of your company’s OSHA 300A logs for the previous three calendar years.

☐ If proposing to use a subcontractor for any of the work, additionally submit a copy of your proposed subcontractor’s OSHA 300A logs for the previous three calendar years.