B08_Solicitation_Attach_3_Experience_Questionaire.xls
XLS spreadsheet 38 KB Posted
- Attached to
- THRO - REPAINT AND REPAIR PVR HOUSE
- Solicitation number
- 140P6326Q0005
About this file
This is an Experience Questionnaire form required as part of a Request for Quotation (RFQ) for painting and repair services at the Theodore Roosevelt National Park house. The National Park Service Midwest Region is soliciting this work under solicitation number 140P6326Q0005.
The questionnaire requires contractors to provide comprehensive information about their qualifications and capacity to perform the project. Respondents must submit their company name, address, telephone number, and business type, along with years of experience in their line of work and as a prime contractor. Contractors must list painting projects completed within the last five years, including contract amounts, project types, completion dates, and references for verification. The form also requests information on all current contract commitments, including contract numbers, award amounts, percentage completion status, and expected completion dates. Contractors must disclose any history of incomplete work or projects requiring performance bonds, with explanations of circumstances. Additionally, the questionnaire addresses organizational capacity by requesting minimum and maximum employee availability, payroll information, and equipment available for the project. The form requires identification of principal individuals assigned to the project, including their names, positions, years of experience, and type of work performed. Financial responsibility documentation is required, either through direct submission of financial institution information or a letter from the contractor's bank addressing account status. The certification statement requires the contractor to attest that all information provided is complete and correct and authorizes the National Park Service to verify references and capability to perform the work.
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Text version
Sheet1
| 1. Contractors Name, Address, & Telephone No.: | 2. Type of Business | ||||||
| Name: | |||||||
| Address: | Company | ||||||
| Corporation | |||||||
| Non-profit Org | |||||||
| Telephone No.: | Co-partner | ||||||
| Individual | |||||||
| 3. How many years experience do you have in this line of work? | Years | ||||||
| 4. How many years experience as a prime contractor? | Years | ||||||
| 5. List painting type projects your business has completed in the last 5 years: | |||||||
| CONTRACT | |||||||
| AMOUNT | TYPE OF | ||||||
| PROJECT | DATE | ||||||
| COMPLETED | NAME, ADDRESS & TELEPHONE NO.TO |
CONTACT FOR INFORMATION
| 6. List all of your firms current contract commitments: | |||||
| CONTRACT | |||||
| NUMBER | AWARD | ||||
| AMOUNT | NAME, ADDRESS, & PHONE NO. | ||||
| TO CONTACT FOR INFORMATION | PERCENT | ||||
| COMPLETED | DATE |
COMPLETED
| 7a. Have you ever failed to complete any work awarded to you? | Yes | No | ||||||||||||
| 7b. Has work ever been completed by performance bond? | Yes | No | ||||||||||||
| 7c. If "Yes" to either item 7a or 7b, specify locations and reason why: | ||||||||||||||
| 8. Organization that will be available for this project: | ||||||||||||||
| a. Minimum No. of employees: | and maximum No. of employees: | |||||||||||||
| b. Are employees regularly on your payroll? | Yes | No | ||||||||||||
| c. Specify equipment available for this project: | ||||||||||||||
| 9. List the experience of principal individuals to be used on this project: | ||||||||||||||
| INDIVIDUALS | ||||||||||||||
| NAME | PRESENT | |||||||||||||
| POSITION | YEARS | |||||||||||||
| EXPERIENCE | TYPE OF WORK | |||||||||||||
| 10. Financial Responsibility: | ||||||||||||||
| (in lieu of this, you may submit a letter from your | ||||||||||||||
| financial institution that addresses the status and standing of your accounts) | ||||||||||||||
| Name of Financial Institution | ||||||||||||||
| Address: | ||||||||||||||
| Contact Name | ||||||||||||||
| Contact Phone Nbr | ||||||||||||||
| 11. Remarks | ||||||||||||||
| CERTIFICATION: I certify that all 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. | ||||||||||||||
| NAME | TITLE | DATE |
EXPERIENCE QUESTIONNAIRE
Instructions: This form may be completed manually or by using MS Excel. See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
Sheet2
Sheet3
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