B08_Solicitation_Attachment_3_Experience_Questionnaire.xlsx
XLSX spreadsheet 22 KB Posted
- Attached to
- REPLACE CARPET IN VISITOR CENTER/ADMIN Federal contract opportunity
- Solicitation number
- 140P6323Q0057
About this file
This document contains an experience questionnaire for contractors to complete related to Solicitation Number 140P6323Q0057 from the Department of the Interior National Park Service Midwest Region to replace carpet in a visitor center and administrative building. The experience questionnaire collects information on the contractor's experience, current commitments, past performance, financial responsibility, available personnel and equipment, and certifies the contractor's ability and intent to complete the project as specified. Key details include requesting the contractor's years of experience in this line of work and as a prime contractor, listing relevant completed projects in the last three years, current contract commitments, failures to complete work and performance bond issues, personnel available and their qualifications, and the contact information for the contractor's financial institution.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| B08_Solicitation_Attachment_2_Limitations_on_Subcontracting_Report.xlsx | XLSX spreadsheet | |
| Sol_140P6323Q0057.pdf | ||
| B08_Solicitation_Attachment_6_Carpet_Price_Schedule.docx | DOCX document | |
| B08_Solicitation_Attachment_5_Drawings__upper_and_lower_levels.pdf | ||
| B08_Solicitation_Attachment_4_WD_2015-5377.pdf | ||
| B08_Solicitation_Attachment_1_Statement_of_Work_(SOW)_WICA_VC_Carpet.doc | DOC document |
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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 UEI 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 relevant projects related to security system installation your business has completed in the last 3 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 with proper qualifications/certifications 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 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.
SIGNATURE 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
File details come from the government source that posted it. Updated .