Attachment_5_-_Financial_and_Technical_Capability.pdf

ATTACHMENT 5

FINANCIAL & TECHNICAL CAPABILITY STATEMENT

Before awarding any Government contract, the Contracting Officer must determine that a proposed contractor is responsible. As used here, the term “responsible” means the Contracting Officer can reasonably expect satisfactory contract performance. A proposed contractor must have or be able to obtain (1) adequate financial resources, (2) be able to comply with the required or proposed delivery or performance schedule, (3) have a record of satisfactory performance , (4) have a satisfactory record of integrity and business ethics, (5) have the necessary organization, experience & technical skills needed, (6) have or be able to obtain production and technical equipment & facilities needed, and (7) be otherwise qualified and eligible to receive an award under applicable laws and regulations. The following information is needed for this determination and will be treated as confidential. The proposed contractor must demonstrate responsibility to the full satisfaction of the Contracting Officer. If the information is not provided or is incomplete the Contracting Officer may not be able to find a proposed contractor responsible.

* * Sign this form in all places indicated and attach copies of documents requested! * *

1. FINANCIAL: PROVIDE INFORMATION ABOUT THE FINANCIAL POSITION OF YOUR FIRM.

a. CONTRACT FINANCING IS NOT AUTHORIZED UNDER THIS SOLICITATION. THEREFORE; DO YOU HAVE, OR ARE YOU ABLE TO OBTAIN, ADEQUATE FINANCIAL RESOURCES FOR PERFORMANCE OF THIS

CONTRACT. [___] YES [___] NO EXPLAIN: __________________________________________________

b. DO YOU HAVE OR ARE YOU ABLE TO OBTAIN THE INSURANCE, AND THE BONDING AND/OR PAYMENT

PROTECTION AS MAY BE REQUIRED FOR THIS CONTRACT? [___] YES [___] NO

c. LIST YOUR BUSINESS’ BANK/FINANCIAL INSTITUTION, AND SURETY INFORMATION.

NAME PHONE/FAX NO COMPLETE ADDRESS AND ZIP CODE TYPE ACCOUNT

2. BUSINESS ACTIVITIES: PROVIDE ANY CONTRACTS THAT YOU HAVE HAD WITH GOVERNMENT AGENCIES.

NAME OF (Include Point of Contact, DATE(s) AND AGENCY Address and Phone No.) TYPE OF WORK PERFORMED LENGTH OF CONTRACT $ VALUE OF CONTRACT

3. PAST PERFORMANCE/EXPERIENCE REFERENCES: ON A SEPARATE PAGE, PLEASE

PROVIDE A MINIMUM OF THREE (3) BUT NO MORE THAN SEVEN (7) REFERENCES; THAT IS, COMMERCIAL OR NON-COMMERCIAL (ORGANIZATIONS, BUSINESSES, OR RESIDENTIAL) WITH WHOM YOU HAVE HAD CONTRACTS TO PROVIDE SIMILAR PRODUCTS AND/OR PERFORM SIMILAR WORK IN THE PAST SEVEN (7) YEARS. INCLUDE THE FOLLOWING INFORMATION: COMPANY NAME, POINT OF CONTACT, COMPLETE

ADDRESS, TELEPHONE NUMBER, CONTRACT VALUE AND DURATION, DESCRIPTION OF PRODUCTS

PROVIDED AND WORK PERFORMED.

4. AUTHORIZATION FOR RELEASE OF INFORMATION: ENTER INFORMATION, SIGN & DATE.

I authorize all of the listed references to release financial or business data or records to the National Park Service (NPS) upon request.

Name & Title of Offeror:_________________________________________________________

Signature: _______________________________________________ Date: _______________

5. ABILITY TO COMMENCE PERFORMANCE: CAN YOU BEGIN PERFORMANCE EARLY TO MID JULY

2015 AND COMPLETE THE WORK, UNINTERRUPTED, IN ITS ENTIRETY WITHIN THE PERFORMANCE PERIOD

SPECIFIED IN THE SOLICITATION?

[___] YES [___] NO IF NO, EXPLAIN ON SEPARATE PAGE.

6. PERSONNEL: ON A SEPARATE PAGE, PROVIDE A BRIEF RESUME OF KEY INDIVIDUALS WHO

WILL PERFORM THIS CONTRACT. GIVE NAMES, POSITIONS, TRAINING, EDUCATION, EXPERIENCE, & OTHER QUALIFICATIONS. ALSO, DESCRIBE HOW YOU WILL MEET THE CONTRACT REQUIREMENTS FOR

ON-SITE MANAGEMENT AND EMPLOYEES.

7. RELATIONSHIP WITH THE GOVERNMENT: IS THE OWNER OR ANY OFFICIAL OF THE FIRM AN

EMPLOYEE OF THE U.S. GOVERNMENT OR AN IMMEDIATE FAMILY MEMBER RESIDING IN THE SAME

HOUSEHOLD OF SUCH PERSON?

[___] YES [___] NO IF YES, EXPLAIN. INCLUDE NAME, POSITION HELD, RELATIONSHIP

8. RESOURCES: DO YOU HAVE OR ARE YOU ABLE TO OBTAIN THE PERSONNEL, EQUIPMENT,

MATERIALS, AND SOURCES REQUIRED FOR TIMELY AND COMPLETE PERFORMANCE OF THIS CONTRACT IF

AWARD IS MADE TO YOUR FIRM?

[___] YES [___] NO IF YOU DO NOT ALREADY HAVE ALL OF THE RESOURCES AVAILABLE, EXPLAIN

YOUR STRATEGY OR PLAN FOR ACQUIRING THEM?

9. OTHER AUTHORITIES: DUE TO THE URGENCY WHICH MAY EXIST IN MAKING A RESPONSIBILITY

DETERMINATION, IF YOU ARE UNABLE TO BE IMMEDIATELY REACHED TO PROVIDE ADDITIONAL

INFORMATION OR CLARIFICATION OF YOUR RESPONSES SUBMITTED ON THIS FORM OR REGARDING YOUR BID SUBMITTAL, ARE THERE ANY OTHER INDIVIDUALS WHO HAVE THE AUTHORITY TO RESPOND ON

BEHALF OF YOU OR YOUR FIRM? [___] YES [___] NO IF YES, PROVIDE THEIR NAME(S),

POSITION, AND CONTACT INFORMATION. ALSO INDICATE IF THE INDIVIDUAL(S) HAS AUTHORITY TO SIGN AND/OR ACT ON YOUR OR YOUR FIRM’S BEHALF REGARDING ANY FOLLOW-ON CONTRACT ACTION OR

ACTIVITIES WHICH MAY RESULT.

Name & Title of Offeror:_________________________________________________________

Signature: _______________________________________________ Date: __________

10. CERTIFICATIONS: READ CAREFULLY THEN COMPLETE INFORMATION REQUESTED BELOW.

I certify that the information provided is true and may be relied upon in determining my responsibility. If the information is incorrect, incomplete, unable to be validated, or misleading, I understand and agree that sufficient basis exists to determine me nonresponsible for the performance of the contract, or, if the contract has been awarded, to terminate the contract for cause based upon fraud or misrepresentation in its inception.

COMPLETE BUSINESS ______________________________ NAME & TITLE ______________________________

NAME AND ADDRESS: OF OFFEROR:

_______________________________ DUNS #: _____________________________

PHONE NUMBER: _______________________________ SIGNATURE: _____________________________

FAX NUMBER: _______________________________ DATE: _____________________________

E-MAIL ADDRESS: _______________________________