B08_Solicitation_attach_3_Experience_Questionaire.xls

XLS spreadsheet 38 KB Posted

Attached to
MIMI DELTA-01 PAVEMENT REPAIR
Solicitation number
140P6326Q0009
Issued by

About this file

This is an Experience Questionnaire form that contractors must complete to demonstrate their qualifications for the Minuteman Missile Historic Site asphalt parking lot repair project (Solicitation 140P6326Q0009), issued by the Department of the Interior National Park Service Midwest Region.

The form requires contractors to provide comprehensive background information including company name, business type, Unique Entity Identifier (UEI), and contact details. Contractors must document their experience in road and parking lot construction, specifying years in the field and years operating as a prime contractor. The questionnaire requests a detailed list of completed projects from the last three years with contract amounts, project types, completion dates, and references. Contractors must also disclose current contract commitments, their percentage completion status, and anticipated completion dates. The form addresses contractor reliability through questions about failed projects and performance bonds. Additionally, contractors must specify the organization's staffing capacity (minimum and maximum employees), payroll status, and available equipment for the project. Principal individuals assigned to the work must be listed with their positions and relevant experience. Financial responsibility is demonstrated either through bank account information or a letter from a financial institution confirming the contractor's financial standing. The certification section requires the applicant to attest that all information provided is complete and accurate, authorizing the National Park Service to verify stated capabilities and contact provided references.

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Sheet1

1. Contractors Name, Address, & Telephone No.:2. Type of Business
Name:
Address:Company
Corporation
UEI #: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 the road/parking lot projects your business has completed in the last 3 years:
CONTRACT
AMOUNTTYPE OF
PROJECTDATE
COMPLETEDNAME, ADDRESS & TELEPHONE NO.TO

CONTACT FOR INFORMATION

6. List all of your firms current contract commitments:
CONTRACT
NUMBERAWARD
AMOUNTNAME, ADDRESS, & PHONE NO.
TO CONTACT FOR INFORMATIONPERCENT
COMPLETEDDATE

COMPLETED

7a. Have you ever failed to complete any work awarded to you?YesNo
7b. Has work ever been completed by performance bond?YesNo
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?YesNo
c. Specify equipment available for this project:
9. List the experience of principal individuals to be used on this project:
INDIVIDUALS
NAMEPRESENT
POSITIONYEARS
EXPERIENCETYPE 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.
NAMETITLEDATE

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

File details come from the government source that posted it. Updated .