Experience_Questionnaire.pdf
PDF 556 KB Posted
- Attached to
- Vault Toilet Installation Federal contract opportunity
- Solicitation number
- 140P6422Q0054
About this file
This document provides details for a federal contract solicitation to replace four vault toilets at Voyageurs National Park. The National Park Service Midwest Region is seeking quotes for a firm-fixed price contract awarded in August 2022, with work to be completed within 90 days of the notice to proceed. The project value is between $100,000 and $250,000. Offerors must be registered in SAM and have active representations and certifications. Quotes are due August 2nd. The site visit was held on July 12th, with any questions due within 5 days thereafter. The NAICS code is 238320 for nonresidential building construction and it is set aside 100% for small businesses. The prevailing wage determination is for St. Louis County, Minnesota.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Statement_of_Work.pdf | ||
| Attachment__-_Vaccination_Certification_Notification_CWB.pdf | ||
| Sol_140P6422Q0054.pdf | ||
| DOL_Wage_Determination.pdf | ||
| Price_Schedule.pdf | ||
| Attachment__-_Certification_of_Vaccination_Form.pdf |
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Text version
1. Contractors Name, Address, & Telephone No.: 2. Type of Business
Company Corporation Non-profit Org Co-partner 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:
6. List all of your firms current contract commitments:
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:
CONTRACT
NUMBER
AWARD
AMOUNT
NAME, ADDRESS, & PHONE NO.
TO CONTACT FOR INFORMATION
PERCENT
COMPLETED
DATE
COMPLETED
Telephone No.:
Address:
Name:
SAM DUNS No:
CONTRACT
AMOUNT
TYPE OF
PROJECT
DATE
COMPLETED
NAME, ADDRESS & TELEPHONE NO.TO
CONTACT FOR INFORMATION
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.
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:
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
INDIVIDUALS
NAME
YEARS
EXPERIENCE TYPE OF WORK
PRESENT
POSITION
SIGNATURE TITLE DATE
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.
File details come from the government source that posted it. Updated .