Business Management Questionaire.pdf

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Landfill Services Base + 4 Option Years FCI Pekin, IL
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15B41122Q00000013
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BUSINESS MANAGEMENT QUESTIONNAIRE

(a) Provide the work distribution, by percentage, among commercial contracts and government contracts (including prime and subcontracts).

COMMERCIAL: _________percent GOVERNMENT: _________percent

(b) List the last three contracts awarded to your firm which are of a related nature, indicating for each the following:

(1) (a) Customer & Address ____________________________

(Phone) __________________

(b) Contract Number ______________________________

(c) Person to Contact ________________________________ (Phone) ___________________

(d) Type of Work _______________________________

(e) Amount of Contract $____________________________

(f) Contract Status [__] Active [__] Complete

(2) (a) Customer & Address _____________________________

(Phone) ___________________

(b) Contract Number ______________________________

(c) Person to Contact ________________________________ (Phone) ____________________

(d) Type of Work _______________________________

(e) Amount of Contract $____________________________

(f) Contract Status [__] Active [__] Complete

BUSINESS MANAGEMENT QUESTIONNAIRE

(3) (a) Customer & Address _____________________________

(Phone) ___________________

(b) Contract Number ______________________________

(c) Person to Contact ________________________________ (Phone) ____________________

(d) Type of Work _______________________________

(e) Amount of Contract $____________________________

(f) Contract Status [__] Active [__] Complete

(4) Bank Reference:

(a) Name of Bank _____________________________________

(b) Address _____________________________________ (Phone) _____________________________

(c) Person to Contact ________________________________ (Phone) _____________________________

(5) Total estimated amount of work under this contract that your firm will complete (excluding subcontractors): _______________________percent

NOTE: Issuing the firm and/or individual(s) performing the services a 1099 form in lieu of a W2 form for reporting their earned income is considered subcontracting.

(6) Please provide your DUNS (Data Universal Numbering System) number

(7) If applicable, please provide your Parent Company's DUNS (Data Universal Numbering System) number ________________________

(8) If the annual representations and certifications have been completed electronically at http://SAM.gov. Please provide your TIN (Taxpayer Identification Number) number________________________ http://sam.gov/

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