7_PROPOSAL_SUBMISSION_PACKAGE.docx

SOLICITATION P16PS00872: ATTACHMENT #5

PROPOSAL SUBMISSION PACKAGE

MAY 12, 2016

INSTRUCTIONS: The following forms should be used to prepare proposals for the subject solicitation as applicable. The forms included in these submissions do not count against page limitations otherwise provided.

CONTENTS:

For Technical Volume:

1. Experience Questionnaire

2. Past Performance Questionnaire

3. Hazardous Materials Identification Listing

4. Key Personnel Qualifications

For Business & Price Volume:

5. General References

Experience Questionnaire READ CAREFULLY: The purpose of this form is for the offeror to list projects performed that are similar to the work described in this solicitation. Provide a minimum of 5 projects in the past 10 years. Use this form to address your familiarity with the Statement of Work and with the evaluation criteria described in the solicitation. Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their experience may be considered by others to be less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s experience.

Name of Contractor/Offeror:

Project Location:

Name of Owner:

Address of Owner:

Telephone Number:

Project Value:

Dates of Construction:

Description of the Project and Scope of Offeror’s Work

Performance Remarks

Description of the Project and Scope of Offeror’s Work (continuation)

Performance Remarks (continuation)

PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS: Offeror to complete Sections I and II and transmit questionnaire to reference listed in Section II Reference to complete Sections III and IV and transmit back to Contracting Officer (see contact information at bottom of form)

I. CONTRACT IDENTIFICATION

CONTRACTOR ADDRESS:

CONTRACT TYPE:

[ ] FIRM-FIXED-PRICE

[ ] COST REIMBURSEMENT

[ ] OTHER____________________________

[ ] ACTIVE [ ] COMPLETED

[ ] ROUTINE [ ] COMPLEX

TOTAL WITH MODS $___________________

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY/CLIENT (CUSTOMER) NAME:

TITLE/PHONE:

III. PAST PERFORMANCE RATING

2. TIMELINESS:

3. BUSINESS RELATIONS:

IV. COMMENTS

Provide any additional comments for items in Section III

POC SIGNATURE/DATE:

Please provide contact information where you may be reached during normal business hours:

National Park Service/ Denver Service Center Contact Information:

Contracting Officer: Victoria Nosal Contract Specialist: Paula Johnson

12795 West Alameda Parkway Lakewood, CO 80228

OR EMAIL FORM TO: Victoria_Nosal@nps.gov and Paula_Johnson@nps.gov

HAZARDOUS MATERIALS IDENTIFICATION LISTING

In accordance with Clause 52.223-3, Hazardous Material Identification and Material Safety Data, of the Contract, contractor is required to identify any hazardous materials that will be delivered under this contract.

List below all known hazardous materials to be used in performance of the work and submit with the proposal/bid. If material components are unknown at the time of submission, respond with a statement to that effect.

Key Personnel Qualifications READ CAREFULLY: The purpose of this form is for the Offeror to list the qualifications of all key personnel as described in the Instructions, Conditions, and Notices to Offerors (Section L). Use additional sheets as needed.

Experience and qualifications include those jobrelated training courses; certificates and licenses; honors; performance awards; and specialty skills that are relevant to the proposed project. Provide dates, but do not send documents.

Provide the state in which registration or license is held and the registration or license number. Fill in the information by typing or printing legibly.

Name of Contractor/Offeror:

Personnel Information:

Name:

Job Title:

Education and Professional Registration:

Top Educational Level Obtained:

Year:

Area of Specialization:

Professional Registrations:

Area of Specialization:

Experience and Qualifications

General References READ CAREFULLY: The purpose of this form is for the offeror to provide the Government with general references in the spaces provided. Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their relationships with the references may be considered less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record. Provide explanations on separate sheets as necessary.

Name of Contractor/Offeror:

Surety

Name of Surety:

Address of Surety:

Name of Agent:

Telephone Number:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Insurance Company

Name:

Address:

Name of Agent:

Telephone Number:

Types of Policies:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Material Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

Material Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

MATERIAL Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material: