B08 Solicitation_Attachment 3 - Tech Fin and PP Statement.pdf

140P6220Q0045 ATTACHMENT 3

TECHNICAL, FINANCIAL & PAST PERFORMANCE STATEMENT

Before awarding any Government contract, the Contracting Officer must determine that a proposed contractor is responsible. As used here, the term “responsible” means the Contracting Officer can reasonably expect satisfactory contract performance. A proposed contractor must have or be able to obtain (1) adequate financial resources, (2) be able to comply with the required or proposed delivery or performance schedule, (3) have a record of satisfactory performance , (4) have a satisfactory record of integrity and business ethics, (5) have the necessary organization, experience & technical skills needed, (6) have or be able to obtain production and technical equipment & facilities needed, and (7) be otherwise qualified and eligible to receive an award under applicable laws and regulations. The following information is needed for this determination and will be treated as confidential. The proposed contractor must demonstrate responsibility to the full satisfaction of the Contracting Officer. If the information is not provided or is incomplete the Contracting Officer may not be able to find a proposed contractor responsible.

* * Sign this form in all places indicated and attach copies of documents requested! * *

1. FINANCIAL: PROVIDE INFORMATION ABOUT THE FINANCIAL POSITION OF YOUR FIRM.

a. CONTRACT FINANCING IS NOT AUTHORIZED UNDER THIS SOLICITATION. THEREFORE; DO YOU HAVE, OR ARE YOU ABLE TO OBTAIN, ADEQUATE FINANCIAL RESOURCES FOR PERFORMANCE OF THIS

CONTRACT.

[___] YES [___] NO EXPLAIN: __________________________________________________

b. DO YOU HAVE OR ARE YOU ABLE TO OBTAIN THE INSURANCE, AND THE BONDING AND/OR PAYMENT PROTECTION THAT IS REQUIRED FOR THIS CONTRACT AND PROVIDE A CERTIFICATE OF INSURANCE TO

THE GOVERNMENT CONTRACTING AGENCY WITHIN THREE (3) CALENDAR DAYS AFTER CONTRACT

AWARD? [___] YES [___] NO

c. LIST YOUR BUSINESS’ BANK/FINANCIAL INSTITUTION, AND SURETY INFORMATION.

NAME PHONE/FAX NO COMPLETE ADDRESS AND ZIP CODE TYPE ACCOUNT

2. TECHNICAL CAPABILITY: ON A SEPARATE PAGE, PROVIDE DETAILS ON AT LEAST THREE (3) COMMERCIAL HVAC INSTALLATIONS THAT QUOTER HAS PERFORMED WITHIN THE PAST FIVE (5) YEARS, UTILIZING EQUIPMENT/PRODUCTS OF THE MANUFACTURER THAT QUOTER PROPOSES TO INSTALL FOR THIS PROJECT. INCLUDE THE FOLLOWING FOR EACH PROJECT LISTED: LABEL THE ADDITIONAL PAGES

AS “APPENDIX A TO ATTACHMENT 3”:

(i) The company/business/organization/individual for whom the work was performed.

(ii) Location where work was performed.

(iii) A reference point of contact, phone number, e-mail address.

(iv) Brief description of the work performed and dollar value

(v) Manufacturer of the equipment/products installed.

(vi) Date Performed

3. AUTHORIZATION FOR RELEASE OF INFORMATION: ENTER INFORMATION, SIGN & DATE.

I authorize all of the listed references to release financial or business data or records to the National Park Service (NPS) upon request.

Name & Title of Quoter:_________________________________________________________

Signature: _______________________________________________ Date: _______________

4. ABILITY TO COMMENCE PERFORMANCE: IT IS ANTICIPATED THE CONTRACT WILL BE

AWARDED PRIOR TO OCTOBER 1, 2020. IF YOUR FIRM IS AWARDED THE CONTRACT, WILL YOU BE ABLE TO PROVIDE THE GOVERNMENT WITH THE REQUIRED PROOF OF LIABILITY INSURANCE WITHIN FIVE (5) CALENDAR DAYS FROM THE DATE OF CONTRACT AWARD AND COMMENCE PERFORMANCE WITHIN FIVE (5) CALENDAR DAYS FROM THE DATE THE NOTICE TO PROCEED IS ISSUED BY THE CONTRACTING OFFICER.

[___] YES [___] NO IF NO, EXPLAIN.

5. ABILITY TO COMPLETE PERFORMANCE: IF YOUR FIRM IS AWARDED THE CONTRACT, CAN ALL DELIVERABLES OF THE CONTRACT BE PROVIDED TO THE GOVERNMENT AND THE WORK SUCCESSFULLY COMPLETED WITHIN NINETY (90) CALENDAR DAYS FROM THE DATE THE CONTRACTING OFFICER ISSUES THE NOTICE TO PROCEED TO YOU? (Note, the NTP is anticipated to be issued within 7-10 calendar days from the contract award date.)

[___] YES [___] NO IF NO, EXPLAIN.

6. TECHNICAL PERSONNEL: ON A SEPARATE PAGE, PROVIDE DOCUMENTATION THAT THE

INDIVIDUALS PERFORMING THE WORK POSSESS THE QUALIFICATIONS AND CAPABILITIES REQUIRED TO

PROVIDE THE PRODUCTS AND PERFORM THE WORK AS STATED IN ATTACHMENT 1. LABEL THE

ADDITIONAL PAGE(S) AS “APPENDIX B TO ATTACHMENT 3”:

7. RELATIONSHIP WITH THE GOVERNMENT: IS THE OWNER OR ANY OFFICIAL OF THE FIRM AN

EMPLOYEE OF THE U.S. GOVERNMENT OR AN IMMEDIATE FAMILY MEMBER RESIDING IN THE SAME

HOUSEHOLD OF SUCH PERSON?

[___] YES [___] NO IF YES, EXPLAIN. INCLUDE NAME, POSITION HELD, RELATIONSHIP

8. RESOURCES: DO YOU HAVE OR ARE YOU ABLE TO OBTAIN THE PERSONNEL, EQUIPMENT,

MATERIALS, AND SOURCES REQUIRED FOR TIMELY AND COMPLETE PERFORMANCE OF THIS CONTRACT IF

AWARD IS MADE TO YOUR FIRM?

[___] YES [___] NO IF YOU DO NOT ALREADY HAVE ALL OF THE RESOURCES AVAILABLE,

EXPLAIN YOUR STRATEGY OR PLAN FOR ACQUIRING THEM?

9. SAFETY / ACCIDENT PREVENTION / ENVIRONMENTAL PROGRAM: CONTRACTORS MUST

BE COMMITTED TO PROVIDING A SAFE AND HEALTHFUL WORK ENVIRONMENT FOR ALL OF ITS EMPLOYEES

AND OTHERS IN THE PERFORMANCE OF THIS CONTRACT. CONTRACTORS ARE TO MANAGE AND

CONDUCT BUSINESS OPERATIONS IN A MANNER THAT OFFERS MAXIMUM PROTECTION TO EACH AND EVERY EMPLOYEE AND ANY OTHER PERSON THAT MAY BE AFFECTED BY CONTRACTOR’S OPERATIONS.

CONTRACTORS ARE RESPONSIBLE FOR KNOWING AND ENSURING COMPLIANCE TO ALL LOCAL, STATE, AND FEDERAL REGULATIONS PERTAINING TO THE SERVICES BEING PROVIDED UNDER THIS CONTRACT.

DOES QUOTER HAVE A SAFETY / ACCIDENT PREVENTION / ENVIRONMENTAL PROGRAM IN PLACE WHICH

ADDRESSES THE AFOREMENTIONED?

[___] YES [___] NO

Name & Title of Quoter:_________________________________________________________

Signature: _______________________________________________ Date: _______________

10. PAST PERFORMANCE OF QUOTER: PROVIDE INFORMATION AND DOCUMENTATION ON

SEPARATE PAGES AND LABEL “APPENDIX C TO ATTACHMENT 3”:

LIST AT LEAST THREE (3), BUT NOT MORE THAN FIVE (5) CONTRACTS THAT QUOTER HAS HAD WITH NON- GOVERNMENTAL AND/OR GOVERNMENTAL ENTITIES, WITHIN THE PAST FIVE (5) YEARS. THE CONTRACTS / PROJECTS THAT QUOTER LISTS FOR PAST PERFORMANCE CAN BE, BUT ARE NOT REQUIRED TO BE, SPECIFIC TO HVAC WORK. AT LEAST TWO OF THE THREE CONTRACTS / PROJECTS MUST BE PROJECTS

OF A NATURE WHERE QUOTER WAS THE PRIME ON THE CONTRACTS/PROJECTS. PROVIDE THE

FOLLOWING INFORMATION FOR EACH OF THE CONTRACTS / PROJECTS LISTED. IF THE

CONTRACTS/PROJECTS ARE THE SAME AS THOSE YOU HAVE LISTED IN ITEM 2 OF THIS ATTACHMENT, INDICATE BELOW AND REFER TO THE INFORMATION PROVIDED IN ITEM 2.

a. Name of the Entity with whom the contract/project was with.

b. Point of Contact: Entity’s reference point of contact, phone number, and e-mail address.

c. Location Where Work was Performed

d. Brief Description of the Work Performed

e. Dollar Value

f. Date and Duration of Contract

11. OTHER AUTHORITIES: DUE TO THE URGENCY WHICH MAY EXIST IN MAKING A RESPONSIBILITY

DETERMINATION, IF YOU ARE UNABLE TO BE IMMEDIATELY REACHED TO PROVIDE ADDITIONAL

INFORMATION OR CLARIFICATION OF YOUR RESPONSES SUBMITTED ON THIS FORM OR REGARDING YOUR QUOTE SUBMITTAL, ARE THERE ANY OTHER INDIVIDUALS WHO HAVE THE AUTHORITY TO RESPOND ON

BEHALF OF YOU OR YOUR FIRM? [___] YES [___] NO IF YES, PROVIDE THEIR NAME(S),

POSITION, AND CONTACT INFORMATION. ALSO INDICATE IF THE INDIVIDUAL(S) HAS AUTHORITY TO SIGN AND/OR ACT ON YOUR OR YOUR FIRM’S BEHALF REGARDING ANY FOLLOW-ON CONTRACT ACTION OR

ACTIVITIES WHICH MAY RESULT.

12. CERTIFICATIONS: READ CAREFULLY THEN COMPLETE INFORMATION REQUESTED BELOW.

I certify that the information provided is true and may be relied upon in determining my technical acceptance, performance, and meeting the standards as a responsible contractor. If the information is incorrect, incomplete, unable to be validated, or misleading, I understand and agree that sufficient basis exists to determine my quote nonresponsive, not technically acceptable, and/or me nonresponsible for the performance of the contract; or, if the contract has been awarded, to terminate the contract for cause based upon fraud or misrepresentation in its inception.

COMPLETE BUSINESS ______________________________ NAME & TITLE ______________________________

NAME AND ADDRESS: OF QUOTER:

_______________________________ DUNS #: _____________________________

PHONE NUMBER: _______________________________ SIGNATURE: _____________________________

FAX NUMBER: _______________________________ DATE: _____________________________

E-MAIL ADDRESS: _______________________________