Solicitation_Amendment_GS-05-P-16-SI-D-7002_0001.pdf
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- Solicitation number
- GS-05-P-16-SI-D-7002
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Amendment 0001 Replaces Page 10 of 235 of the RFP to notate that the Pre-Proposal Conference will be held in Rockford Illinois. Amendment 0001 incorporates GSA Form 527 into the RFP.
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Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
(a) By completing items 8 and 15, and returning or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE
2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)
7. ADMINISTERED BY (If other than Item 6) CODE
STANDARD FORM 30 (REV. 10-83)
Prescribed by GSA FAR (48 CFR) 53.243
FACILITY CODE
9A. AMENDMENT OF SOLICITATION
NO.
9B. DATED (SEE ITEM 11)
10A. MODIFICATION OF CONTRACT/ORDER NO.
10B. DATED (SEE ITEM 13)
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.
12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;
13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO.
IN ITEM 10A.
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and authority)
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15C. DATE SIGNED
15A. NAME AND TITLE OF SIGNER (Type or print)
16C. DATE SIGNED
16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
PAGE OF PAGES
6. ISSUED BY CODE
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X)
CODE
15B. CONTRACTOR/OFFEROR
(Signature of person authorized to sign)
16B. UNITED STATES OF AMERICA
(Signature of Contracting Officer)
NSN 7540-01-152-8070
Previous edition unusable
Mechanical Operations & Maintenance Services 327 South Church Street, Rockford, IL
RFP GS-05P-16-SI-D-7002
IL0311ZZ
[THIS NOTICE SHOULD BE REMOVED BEFORE OFFER IS SUBMITTED TO GSA]
GSA Form 1602 – Rev. April 2013
PRE-PROPOSAL CONFERENCE NOTICE
ATTENDENCE FORM
SOLICITATION #:
OPERATION AND MAINTENANCE SERVICES
STANLEY J. ROSZKOWSKI US COURTHOUSE
A pre-proposal conference is scheduled at the time and place set forth below. Please complete and return this form via email to bradley.washington@gsa.gov and brian.weiss@gsa.gov. A Site Visit will be held as part of the pre-proposal conference.
TIME/DATE: August 17, 2016 at 11:00 am
PRE-PROPOSAL CONFERENCE LOCATION:
General Services Administration Property Management Service Center Stanley J. Roskowski US Courthouse 327 South Church Street, Suite 1500 Rockford, Illinois 61101 Email: shawn.lewellen@gsa.gov
PHONE: (815) 316-2484
[ ] I plan to attend the conference.
Number of attendees: .
[ ] I do not plan on attending the conference.
In case of last minute changes, please be sure to include a phone number:
Name:
Company:
Phone:
mailto:bradley.washington@gsa.gov mailto:brian.weiss@gsa.gov mailto:shawn.lewellen@gsa.gov
CONTRACTOR'S QUALIFICATIONS AND FINANCIAL INFORMATION OMB Control Number: 3090-0007 Expiration Date: 9/30/2018
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0007. We estimate that it will take 2.5 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
SECTION I - GENERAL INFORMATION
1A. NAME
1B. STREET ADDRESS
1C. CITY 1D. STATE 1E. ZIP CODE
2. TYPE OF ORGANIZATION (Check one)
A. SOLE PROPRIETORSHIP
B. GENERAL PARTNERSHIP
C. LIMITED PARTNERSHIP
D. CORPORATION
E. SUBCHAPTER S CORPORATION
I. OTHER (Specify below)
3. TAXPAYER ID NUMBER 4. DATE ORGANIZATION ESTABLISHED 5. STATE OF INCORPORATION
6. TRADE STYLE NAME (Provide a copy of filing) 7. KIND OF PRODUCT OR SERVICE PROVIDED
8. FORMER BUSINESS NAME
D. RETAILER
E. OTHER (Specify) B. FIFO
A. LIFO C. AVERAGE COST
D. OTHER (Specify)
11. OWNERSHIP INFORMATION-PARTNERS-PRINCIPAL STOCKHOLDERS-OTHERS
NAME
10. INVENTORY VALUATION METHOD
9. KIND OF BUSINESS
A. MANUFACTURER
B. CONTRACTOR
C. WHOLESALER
TITLE
(If partner, state G(General) or L(Limited) in column)
ACTUAL TITLE G OR L
PERCENT
BUSINESS OWNED
12. PARENT COMPANY (If applicable)
13. IF "YES" TO ANY QUESTION BELOW, PROVIDE DETAILED
INFORMATION IN SECTION VIII, REMARKS YES NO
A. NAME
B. CITY C. STATE
A. HAVE YOU, OR ANY OF YOUR AFFILIATES EVER FILED FOR BANKRUPTCY?
B. DO YOU HAVE ANY JUDGMENTS, LIENS, OR PENDING SUITS?
C. DO YOU HAVE ANY CONTINGENT LIABILITIES?
D. HAVE YOU OR ANY OF YOUR AFFILIATES DISCONTINUED BUSINESS OPERATIONS WITH
OUTSTANDING DEBTS?
SECTION II - GOVERNMENT FINANCIAL AID AND INDEBTEDNESS
14A. ARE YOU DELINQUENT ON ANY FEDERAL DEBT (OMB CIRCULAR A-129)
(If "Yes", provide detailed information, Section VIII, Remarks)
14B. DO YOU OWE THE
GOVERNMENT
FOR ANY
CONTRACT OR
OTHER CLAIMS?
YES NO
IF "YES", COMPLETE THE ITEMS BELOW
AGENCY CLAIM AMOUNT PAYMENT MATURITY BALANCE
15A. AGENCY INVOLVED WITH DELINQUENCY 15B. AMOUNT OF DELINQUENCY ($)
16. ARE YOU
CURRENTLY
RECEIVING
GOVERNMENT
FINANCING?
YES NO
YES
NO (Go to Section III )
17. COMPLETE ITEMS BELOW IF APPLICABLE
A. INDUSTRIAL REVENUE BONDS
B. GUARANTEED LOANS
C. ADVANCED PAYMENTS
D. PROGRESS PAYMENTS
AUTHORIZED ($) IN USE ($) GOVERNMENT AGENCY INVOLVED
E. OTHER (Specify)
GENERAL SERVICES ADMINISTRATION GSA 527 (REV. 10/2015)
F. LIMITED LIABILITY COMPANY
G. JOINT VENTURE
H. TRUST
TYPE OF FINANCING
GSA 527 (REV. 10/2015) PAGE 2
SECTION III - FINANCIAL STATEMENTS
Prepared Financial Statements with notes may be provided in lieu of completing Section III
When financial statements are prepared or certified by independent accountants and transcribed to this form, please furnish the name and address of accountant of accounting firm.
18. ARE YOU THE INCUMBENT CONTRACTOR FOR THIS SOLICITATION?
NO
19A. NAME
19B. STREET ADDRESS
19C. CITY 19D. STATE 19E. ZIP CODE
20. IF TRANSCRIBED STATEMENTS DIFFER FROM INDEPENDENT ACCOUNTANT'S,
PLEASE DESCRIBE ADJUSTMENT IN SECTION VII, REMARKS. ALL OF THE
LISTED FIGURES ARE:
ACTUAL
IN THOUSANDS
IN MILLIONS
U.S. DOLLARS
FOREIGN CURRENCY (Specify)
21. BALANCE SHEET AS OF (Month, Day, Year) 22. FISCAL YEAR ENDS (Month, Day, Year) 23. PREPARED STATEMENTS
YES
ARE ATTACHED
24. ASSETS 25. LIABILITIES AND NET WORTH
A. Current Assets A. Current Liabilities
Cash Short Term cash investments Accounts receivable, less allowance for doubtful accounts of $ Inventories Other current assets (Itemize below)
Total Current Assets
B. Property, Plant and Equipment
Accounts payable Notes payable (current) Current portion of long term debt Accrued expenses Accrued taxes on income/excess profits Other current liabilities (Itemize below)
Total Current Liabilities
B. Other Liabilities
Land Buildings and equipment Leasehold improvements Less accumulated depreciation and amortization
Total Property, Plant and Equipment C. Other Assets
Investments in and advance to affiliated company Goodwill, less amortization Due from officer, employee Other (Itemize below)
Total Other Assets
D. TOTAL ASSETS
Mortgages Bonds Deferred income taxes Other long term debt
Total Other Liabilities
Total Liabilities
C. Minority Interest in Subsidiary D. Net Worth
Preferred stock Common stock Additional paid-in capital Retained earnings/owner's equity Less, Treasury stock
Total Net Worth
E. TOTAL LIABILITIES AND NET WORTH
SECTION IV - INCOME STATEMENT
26. FROM (Month, Day, Year) 27. TO (Month, Day, Year)
A. Net Sales
28. INCOME
Cost and Expenses Cost of Goods Sold Depreciation and Amortization
Selling, General, and Admin. Expenses Interest Expense Other Expenses (Itemize below)
Minority Interest in Earnings of Subsidiaries
Total Costs and Expenses
Earnings Before Taxes Taxes on Income Income Before Extraordinary Items Extraordinary Gains (Losses) Net of Taxes
NET INCOME (LOSS)
ZIP CODE
Yes No
Yes No
A.
B.
C.
CITY STATE ZIP CODE
Yes No
Yes No
AREA CODE NUMBER
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
STREET ADDRESS
37. Maximum Amount Authorized ($)
38. Amount Outstanding ($)
39. Loans Secured by Company's Assets - Real and Personal Property
BANK 1 BANK 2
SECTION V - BANKING AND FINANCE COMPANY INFORMATION
(Please attach a separate sheet using this format for any additional banks.)
ITEM
29. Name of Bank
30. Contact Person
31. Phone Number
32. Fax Number
33. Address
34. Amount Owing ($)
35. Term Loans
36. Line of Credit
D.
SECURED PARTY NAME CONTACT NAME
STREET ADDRESS CITY STATE ZIP CODE
SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)
SECURED PARTY NAME CONTACT NAME
STREET ADDRESS CITY STATE ZIP CODE
SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)
SECURED PARTY NAME CONTACT NAME
STREET ADDRESS CITY STATE ZIP CODE
SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)
SECURED PARTY NAME CONTACT NAME
STREET ADDRESS CITY STATE ZIP CODE
SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)
40. ARE ANY OF THE ASSETS SHOWN ON THE BALANCE SHEET
PLEDGED OR MORTGAGED, EXCEPT AS STATED ABOVE?
41B. TOTAL
LIABILITY ($)
41A. IF CONTRACTOR IS A PARTNERSHIP OR SOLE PROPIERTORSHIP,
ARE THE INDIVIDUAL LIABILITIES OF THE PROPIETOR(S) FOR
FEDERAL AND STATE INCOME AND/OR EXCESS PROFIT TAXES
INCLUDED ON THE BALANCE SHEET?
YES NO
42. ARE YOU NOW IN OR PENDING DEFAULT ON ANY OBLIGATIONS, I.E., BANKS, FINANCIAL INSTITUTIONS, SUPPLIERS, OTHER?
NO YES (Explain in Section VII, Remarks)
NO YES (Provide detailed information in Section VII, Remarks)
GSA 527 (REV. 10/2015) PAGE 3
AREA CODE NUMBER EXTENSION
STREET ADDRESS
CITY STATE
SECTION VI - PRINCIPAL MERCHANDISE OR RAW MATERIAL SUPPLIER INFORMATION
(Please attach separate sheet(s) using this format for additional suppliers.)
43. PAST DUE ACCOUNTS PAYABLE ($)
ITEM 44. SUPPLIER 1 45. SUPPLIER 2
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
STREET ADDRESS
STATECITY ZIP CODE
ITEM 46. SUPPLIER 3 47. SUPPLIER 4
A. Name of Supplier B. Contact Person
C. Telephone
D. Fax
E. Address
F. Amount Now Owing ($) G. High Credit ($)
A. Name of Supplier B. Contact Person
C. Telephone
D. Fax
E. Address
F. Amount Now Owing ($) G. High Credit ($)
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
STREET ADDRESS
CITY STATE ZIP CODE
SECTION VII - CONSTRUCTION/SERVICE CONTRACTS INFORMATION (Public Buildings Service Contracts Only)
CONTRACTS IN FORCE
STREET ADDRESS
CITY STATE ZIP CODE
GSA 527 (REV. 10/2015) PAGE 4
ITEM 48. CONTRACT 1 49. CONTRACT 2
A. Location B. Owner's Name
C. Address
D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date
STREET ADDRESS
CITY STATE ZIP CODE
STREET ADDRESS
CITY STATE ZIP CODE
ITEM
A. Location B. Owner's Name
C. Address
D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date
50. CONTRACT 3 51. CONTRACT 4
STREET ADDRESS
CITY STATE ZIP CODECITY STATE ZIP CODE
STREET ADDRESS
GSA 527 (REV. 10/2015) PAGE 5
C. Address
D. Telephone
E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
ITEM 58. JOB 3 59. JOB 4
A. Location B. Contact's Name
C. Address
D. Telephone
E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
ITEM 60. JOB 5 61. JOB 6
A. Location B. Contact's Name
C. Address
D. Telephone
E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
ITEM 52. CONTRACT 5 53. CONTRACT 6
A. Location B. Owner's Name
C. Address
D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date
STREET ADDRESS
CITY STATE ZIP CODE
STREET ADDRESS
CITY STATE ZIP CODE
ITEM
A. Location B. Owner's Name
C. Address
D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date
54. CONTRACT 7 55. CONTRACT 8
STREET ADDRESS
CITY STATE ZIP CODE
STREET ADDRESS
CITY STATE ZIP CODE
LARGEST JOBS YOU HAVE COMPLETED IN THE LAST FIVE YEARS
ITEM 56. JOB 1 57. JOB 2
A. Location B. Contact's Name
CERTIFICATION
For the purpose of establishing financial responsibility with, or procuring credit from the General Services Administration, we furnish the above as a true and correct statement of our financial condition and further certify that all other statements are true and correct. There has been no material change in the applicant's financial condition since the date of the above statement. We agree to notify you immediately in writing of any materially unfavorable change in our financial condition. In the absence of such notice or of a new and full financial statement, this is to be considered as a continuing statement.
NAME OF BUSINESS BY (Signature of Authorized Official)
NAME OF AUTHORIZED OFFICIAL (Type or print)
TITLE OF AUTHORIZED OFFICIAL (Type or print)
DATE
GSA 527 (REV. 10/2015) PAGE 6
NUMBER
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE NUMBER EXTENSION
AREA CODE NUMBER
STREET ADDRESS
CITY STATE ZIP CODE
64. PRESENT AMOUNT OF BONDING
COVERAGE ($)
65. HAS YOUR APPLICATION FOR SURETY
BOND EVER BEEN DECLINED? (If Yes, please provide detailed information in
Remarks)
66. DURING THE PAST 2 YEARS, HAVE YOU BEEN CHARGED WITH A
FAILURE TO MEET THE CLAIMS OF YOUR SUBCONTRACTORS OR
SUPPLIERS? (If Yes, please provide detailed information in Remarks)
YES NO YES NO
SECTION VIII - REMARKS
REMARKS (Cite those sections of the form relating to your remarks. If additional space is required, attach additional sheet(s).)
LIST COMPANIES FROM WHOM YOU OBTAIN SURETY BONDS
ITEM 62. SURETY COMPANY 1 63. SURETY COMPANY 2
A. Company Name B. Contact's Name
C. Telephone
D. Fax
E. Address
AREA CODE NUMBER EXTENSION
AREA CODE
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| Description[0]: Amendment 0001 Replaces Page 10 of 235 of the RFP to notate that the Pre-Proposal Conference will be held in Rockford, Illinois. |
Amendment 0001 incorporates GSA Form 527 into the RFP.
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| IssuedBy[0]: R5 AMD Chicagoland Services Contracting Team |
230 S. Dearborn St.
Room 3600 Chicago, IL 60604United States
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230 S. Dearborn St.
Room 3600 Chicago, IL 60604United States
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