A15 Attachment 4 Responsiblility Questionair B411.docx
DOCX document 20 KB Posted
- Attached to
- Renovate Facility for Munitions Building B425 Federal contract opportunity
- Solicitation number
- FA671220B0001
About this file
This document contains a solicitation for the renovation of a munitions building. The project consists of demolishing interior storage tanks and concrete pads, patching an existing concrete slab, and renovating an existing 1,176 square foot CMU building for munitions storage at Pittsburgh Air Reserve Station. The estimated value of the project is between $250,000 and $500,000 and the period of performance is 180 calendar days from notice to proceed. This is designated as a 100% HUBZone small business set-aside with a single award to be made. Interested parties must register on the Interested Vendors List and SAM to be eligible for award. The pre-bid site visit is anticipated to be on January 8, 2020 and proposals are due by January 29, 2020. The solicitation can be found on beta.sam.gov and the NAICS code is 236220 with a size standard of $36.5 million average annual receipts.
View the file
Other files for this federal contract opportunity
Show all 36
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT 4
RESPONSIBILITY QUESTIONAIRE
The following information is needed to help evaluate and determine your company responsible. Please complete the following items and submit with your proposal:
A. The names of at least three (3) suppliers that you do business with, to include points of contact and phone numbers.
I. Name of Supplier: _____________________________________________________
Address: ______________________________________________________________
Name of POC: _________________________________________________________
Telephone No: _________________________________________________________
II. Name of Supplier: ____________________________________________________
Address: ______________________________________________________________
Telephone No: _________________________________________________________
III. Name of Supplier: ___________________________________________________
Address: ______________________________________________________________
Telephone No: ________________________________________________
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your proposal a reference sheet for each financial institution that you have a business account with. This sheet may be sent to the banking institution/s in regards to a determination of contractor responsibility as part of the evaluation for award of this solicitation.
TO BE FILLED OUT BY CONTRACTOR:
COMPANY’S NAME: ____________________________________________________________
Point of Contact (POC) Name: _______________________________________________ POC Phone Number: __________________________________________________________ Email: __________________________________________________________
INSTITUTION NAME: __________________________________________________________
POC name: __________________________________________________________________ POC title: _________________________________________________________________ POC phone number: ______________________ fax number: _______________________ Email: __________________________________________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 910th Contracting Squadron, Youngstown ARS, Vienna OH.
| _____________________________________ | ________________________________ | |
| Name/Title | Signature/Date |
DO NOT HAVE THIS SECTION FILLED OUT. IF YOUR FIRM IS SELECTED AS THE POTENTIAL AWARDEE, THIS FORM WILL BE SENT TO YOUR BANKING INSTITUTION FOR COMPLETION.
TO BE FILLED OUT BY FINANCIAL INSTITUTION:
Please give amounts as a range – i.e. low four figures, mid six figures, etc.
Average monthly balance in checking: ________________ Average monthly balance in savings: _________________ Amount of any current loans: ______________ Amount of any lines of credit: ______________ Any late payments or NSF’s? ______________ How long with this institution: ______________ Credit rating with this institution: ______________
I verify that the information provided above is current as of ____________.
| _____________________________________ | ________________________________ | |
| Name/Title | Signature/Date |
LIST OF EQUIPMENT DEDICATED TO PROJECT
(Owned/Rented)
1.
2.
3.
4.
5.
FA671220B0001 Attachment 4
File details come from the government source that posted it. Updated .