B08_Attachment_3_PPQ_Bulk_Coal_STEA.pdf
PDF 218 KB Posted
- Attached to
- STEA - BULK COAL DELIVERY Federal contract opportunity
- Solicitation number
- 140P4526Q0030
About this file
This is a Past Performance Questionnaire for STEA RFQ Bulk Coal Delivery (140P4526Q0030), issued by the National Park Service. The questionnaire is a mandatory form that all quoters must complete to receive consideration for the bulk coal delivery contract.
Contractors must provide basic company information including business type, Unique Entity Identifier (UEI), address, and contact details. The form requires contractors to document their relevant experience in the types of work requested, specifying years of experience in similar work, years as a prime contractor, and years as a sub-contractor. Contractors must list three projects completed within the last five years that are similar in scope and complexity to the proposed service, including contract amounts, project types, completion dates, and reference contact information with names, addresses, email addresses, and telephone numbers. The questionnaire also requires contractors to disclose whether they have failed to complete any awarded work and whether any work required completion under performance or payment bonds, with explanations if applicable. The form includes detailed reference sheets for documenting up to three past experiences, with fields for contract type, contract number, total contract value, agency or firm name, site contact person details, work dates, and a description of duties performed. Handwritten responses must be legible. The completed questionnaire must be returned via email to mary_hallmon@ios.doi.gov. The form concludes with a certification statement requiring the contractor's official to attest under penalty of perjury that all information provided is complete and accurate.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| B08_Attachment_5_Price_Schedule_Bulk_Coal_STEA_0001.pdf | ||
| Sol_140P4526Q0030_Amd_0001.pdf | ||
| Sol_140P4526Q0030.pdf | ||
| B08_Attachment_5_Price_Schedule_Bulk_Coal_STEA.pdf | ||
| B08_Attachment_1_SOW_Bulk_Coal_STEA.pdf | ||
| B08_Attachment_4_Technical_Questionnaire_Bulk_Coal_STEA.pdf |
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Text version
STEA RFQ BULK COAL DELIVERY 140P4526Q0030
Past Performance Questionnaire
Contractor Name: UEI #
Address: City: State: Zip:
Phone Number: Fax Number:
Type of Business:
_____Company ____Co-partnership ______Corp._____ Individual ____Non-Profit Org.
How many years do you or your firm has in the types of work requested by this solicitation?
_________________year(s).
How many years experience in contracting have you or your business had as a Prime Contractor? _________year(s) and/or Sub-contractor: _______(years)
List below the three (3) projects your business has completed within the last five (5) years of the proposed service requested by this solicitation, include the contract amount, the type of project, date completed and your reference contact name, address, email address and telephone number: (SEE ATTACHED SHEET)
Have you ever failed to complete any work awarded to you? ______Yes _____No
Has work ever been completed by performance/payment bond? ______Yes ______No
If “Yes” to either item, specify location and reason:
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 National Park Service with any information needed to verify my capability to perform this project.
Certifying Official Name and Title:
Signature (Sign in Ink):
Date:
PAST EXPERIENCE & REFERENCES
REFERENCES:
This form must be completed by all quoters in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience which is pertinent to this position. Past performance and experience may be a combination of up to two contracts similar in size and complexity to those stated in the Technical Provisions and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training which would enable you to better perform the work outlined in the specifications. Reference information should include a point-of-contact's name, telephone number and e-mail address. (IF
HANDWRITTEN, MUST BE LEGIBLE)
Experience No. 1
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Month/Year work began: Month/Year work ended: ________________________________________
Brief description of duties:
Experience No. 2
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Month/Year work began: Month/Year work ended: ________________________________________
Brief description of duties
Experience No. 3
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Month/Year work began: Month/Year work ended: ________________________________________
Brief description of duties:
Return form to:
Email: mary_hallmon@ios.doi.gov
File details come from the government source that posted it. Updated .