B08_Solicitation_Attachment_5_-_Technical_and_Financial_Capability.pdf

P17PS02555 ATTACHMENT 5

TECHNICAL & FINANCIAL 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: ON A SEPARATE PAGE, LIST ANY CONTRACTS THAT YOU HAVE HAD

WITH GOVERNMENT AGENCIES. AT A MINIMUM, INCLUDE THE FOLLOWING FOR EACH CONTRACT LISTED:

(i) The name of the Agency.

(ii) Location where work was performed.

(iii) A reference point of contact, phone number, e-mail address.

(iv) Brief description of the work performed and dollar value.

(v) Date and duration of the contract.

3. TECHNICAL CAPABILITY / PAST PERFORMANCE: ON A SEPARATE PAGE, PROVIDE

DETAILS ON AT LEAST THREE (3) PROJECTS THAT QUOTER HAS SUCCESSFULLY COMPLETED IN THE PAST THREE (3) YEARS THAT EVIDENCE THE CONTRACTOR HAS PERFORMED AND SUCCESSFULLY COMPLETED THE ELEMENTS BEING RATED FOR AWARD DETERMINATION. THE PROJECTS SHOULD BE OF AT LEAST THE TYPE OF WORK, SIZE AND SCOPE AS DECRIBED IN THIS SOLICITATION. AT A MINIMUM, INCLUDE THE

FOLLOWING FOR EACH PROJECT LISTED:

(i) The company/business/organization/individual for whom the work was performed.

(ii) Location where work was performed.

(iii) A reference point of contact, phone number, e-mail address.

(iv) Brief description of the work performed and dollar value

(v) Date and duration of the project. (Beginning and Ending Dates)

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 Quoter:_________________________________________________________

Signature: _______________________________________________ Date: _______________

5. ABILITY TO COMMENCE PERFORMANCE: IT IS ANTICIPATED THE CONTRACT WILL BE

AWARDED IN EARLY- TO MID-SEPTEMBER 2017 TIMEFRAME. IF YOUR FIRM IS AWARDED THE CONTRACT, WITHIN HOW MANY CALENDAR DAYS CAN YOU BEGIN PERFORMANCE AFTER CONTRACT HAS BEEN

AWARDED?

[_____] INDICATE NUMBER OF CALENDAR DAYS TO COMMENCE WORK.

6. ABILITY TO COMPLETE PERFORMANCE: UPON COMMENCMENT OF THE WORK, WITHIN HOW

MANY CALENDAR DAYS CAN THE WORK REQUIRED OF THE CONTRACT BE COMPLETED IN ITS ENTIRETY?

[_____] INDICATE NUMBER OF CALENDAR DAYS FOR COMPLETION.

7. 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.

8. 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

9. 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?

10. SAFETY / ACCIDENT PREVENTION AND COMMUNICATION PLANS: CONTRACTORS MUST

BE COMMITTED TO PROVIDING A SAFE AND HEALTHFUL WORK ENVIRONMENT FOR ALL OF ITS EMPLOYEES AND OTHERS THAT MAY WORK, VISIT OR ENTER THE WORK SITE. CONTRACTORS ARE TO MANAGE AND CONDUCT BUSINESS OPERATIONS IN A MANNER THAT OFFERS MAXIMUM PROTECTION TO EACH AND EVERY EMPLOYEE AND ANY OTHER PERSON THAT MAY BE AFFECTED BY CONTRACTOR’S OPERATIONS.

THE CONTRACTOR SHALL MAKE EVERY EFFORT TO PROVIDE A WORKING ENVIRONMENT THAT IS FREE FROM ANY RECOGNIZED OR POTENTIAL HAZARD AND ALLOCATE AND PROVIDE ALL RESOURCES NEEDED TO PROMOTE AND EFFECTIVELY IMPLEMENT ITS SAFETY / ACCIDENT PREVENTION AND COMMUNICATION

PLANS.

[___] YES [___] NO QUOTER DOES HAVE A SAFETY / ACCIDENT PREVENTION PROGRAM AND

COMMUNICATIONS PLAN AND HAS SUBMITTED THEM WITH ITS QUOTE.

Name & Title of Quoter:_________________________________________________________

Signature: _______________________________________________ Date: _______________

11. 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 QUOTE 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.

12. 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 my quote nonresponsive, and/or 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 QUOTER:

_______________________________ DUNS #: _____________________________

PHONE NUMBER: _______________________________ SIGNATURE: _____________________________

FAX NUMBER: _______________________________ DATE: _____________________________

E-MAIL ADDRESS: _______________________________