DCEB-2023-R-0006_Att3.pdf
PDF 23 KB Posted
- Attached to
- DC Small Business Census
- Solicitation number
- DCEB-2023-R-0006
- Issued by
- District of Columbia
About this file
This document is an Experience Questionnaire for a solicitation issued by the District of Columbia, Office of the Deputy Mayor for Planning and Economic Development, Contract No. DCEB-2023-R-0006. The questionnaire requests information about the contractor's experience, including the number of years in the line of work, projects completed within the last five years, current contractual commitments, and the capabilities of the contractor's organization and personnel. The solicitation is for a Census of minority- and woman-owned small businesses in the District of Columbia.
The document also includes details on the State and Local Contract Opportunity, which is seeking proposals from qualified contractors to conduct the DC Small Business Census. The contract is being issued by the Government of the District of Columbia, Office of the Deputy Mayor for Planning and Economic Development. The scope of work, pricing terms, set-asides, funding requirements, and other salient details are not provided in the information given.
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Other files
| File | Type | Posted |
|---|---|---|
| DCEB-2023-R-0006_Amd1.pdf | ||
| DCEB-2023-R-0006_Att1.pdf | ||
| DCEB-2023-R-0006_Att2.pdf | ||
| DCEB-2023-R-0006_Amd2.pdf |
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Text version
EXPERIENCE QUESTIONNAIRE
INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any item below. Mark "X" in appropriate boxes.
1. CONTRACTOR NAME, ADDRESS AND TELEPHONE NUMBER
2. SUBMITTED TO (Office Name and Address)
3. BUSINESS
Υ Company Υ Co-partnership Υ Corporation Υ Individual Υ Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years experience in contracting have you or your business had as a (a) prime contractor_____ and/or (b) sub-contractor ______?
6. List below the projects your business has completed within the last five (5) years which are similar in scope and scale to this job.
CONTRACT
AMOUNT
TYPE OF PROJECT DATE
COMPLETED
NAMES, ADDRESS AND TELEPHONE NO. OF OWNER/PERSON TO
CONTACT FOR PROJECT INFORMATION
7. List below all of your firm's contractual commitments running concurrently with the work contemplated by this solicitation:
NUMBER
DOLLAR
AMOUNT
NAME, ADDRESSS AND TELEPHONE
NO. OF BUSINESS/GOVERNMENT
AGENCY INVOLVED
AWARDED
(units)
PERCENT
COMPLETED
DATE
COMPLETED
8a. Have you ever failed to complete any work awarded to you? Υ Yes Υ No 8b. Has work ever been completed by performance bond? Υ Yes Υ No 8c. If "Yes" to either item 8a or 8b specify location(s) and reason(s) why:
9. Organization and work that will be available for this project:
a. (1) Minimum number of employees: ______ and (2) Maximum number of employees:________
b. Are employees regularly on your payroll: Υ Yes Υ No
c. Specify equipment available for this contract: __________________________________________________________________________________
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate: ___________________ and (2) Maximum progress rate:_____________________
10. List below the experience of the principal individuals of your business:
INDIVIDUAL'S NAME PRESENT
POSITION
YEARS OF
EXPERIENCE
MAGNITUDE AND TYPE OF WORK
11. REMARKS - SPECIFY BOX NUMBERS (Attach sheets if extra space is needed to fully answer any of the above questions.)
12a. CERTIFYING OFFICIAL'S NAME AND TITLE
CERTIFICATION
I certify that all of 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 District with any information needed to verify my capability to perform this project.
12B. SIGNATURE (Sign in ink) 13. DATE
File details come from the government source that posted it. Updated .