B08_Solicitation_Attach_3_Experience_Questionnaire.xls

XLS spreadsheet 38 KB Posted

Attached to
BARN SPRINKLER REPAIR SERVICE
Solicitation number
140P6326Q0026
Issued by

About this file

This is an Experience Questionnaire form used by the National Park Service to evaluate contractor qualifications for the Portable Toilets project at Badlands National Park. The form requires prospective contractors to provide comprehensive information about their business capabilities, relevant experience, and financial standing to demonstrate their ability to perform the work.

The questionnaire requests detailed information across multiple categories: contractor identification and business structure; years of experience in the relevant line of work and as a prime contractor; a three-year project history including contract amounts, project types, completion dates, and references; current contract commitments with award amounts and completion status; disclosure of any failed or bonded work; organizational capacity including minimum and maximum employee availability and equipment resources; qualifications and experience of key personnel who will work on the project; and financial responsibility documentation from the contractor's financial institution. The form also includes a certification statement in which the contractor affirms their intent to complete the project as specified, confirms the accuracy of all information provided, and authorizes the National Park Service to verify their capability to perform. Contractors may complete the form manually or using Microsoft Excel, with additional space available in the remarks section for supplementary information. The form requires the contractor's signature, title, and date upon submission.

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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
SAM DUNS No: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 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 with proper qualifications/certifications 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 I intend to complete the project as specified and that my offer conforms to the specifications of the solicitation without deviation unless I provide an alternative proposal. 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.
SIGNATURETITLEDATE

EXPERIENCE QUESTIONNAIRE for Portable Toilets Badlands NP 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 .