Past_Performance_Questionnaire.pdf
PDF 126 KB Posted
- Attached to
- PAGR PORTABLE RESTROOMS W/ OPTION YEAR
- Solicitation number
- 140P4525Q0023
About this file
The document is a Past Performance Questionnaire for solicitation 140P4525Q0023, issued by the National Park Service for portable toilet rental and service. The form requires potential contractors to provide detailed information about their past experience, including three prior contracts similar in size and complexity to the current solicitation. Contractors must list contract details such as work type, total contract value, agency/firm, contact information, work dates, and a brief description of duties. The questionnaire also requires information about the company's years of experience, business type, and whether they have ever failed to complete awarded work or used a performance/payment bond.
The form is designed to help the National Park Service evaluate a contractor's capability and past performance for a portable restroom rental contract. Contractors must complete all sections, including a certification that the information provided is accurate and that references are authorized to verify the company's performance capabilities. The completed questionnaire should be returned via email to the point of contact, Linda Richardson, and will be used as part of the evaluation process for the contract opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140P4525Q0023.pdf | ||
| Technical_Questionnaire.pdf | ||
| A04_Scope_of_work.pdf | ||
| B03_WD_2015-4183.pdf | ||
| PAGR_PORTABLE_TOILETS_PRICE_SCEDULE.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE/REFERENCES
140P4525Q0023 PAGR PORTABLE TOILET RENTAL/SERVICE
140P4525Q0023 POINT OF CONTACT: LINDA RICHARDSON, linda_richardson@nps.gov
Past Performance Questionnaire
Contractor Name: Duns #
Address: City: State: Zip:
Phone Number: Fax Number:
Type of Business:
_____Company ____Co-partnership ______Corp._____ Individual ____Non-Profit Org.
How many years do you or your firm has in the types of work requested by this solicitation?
_________________year(s).
How many years experience in contracting have you or your business had as a Prime Contractor? _________year(s) and/or Sub-contractor: _______(years)
List below the three (3) projects your business has completed within the last five (5) years of the proposed service requested by this solicitation, include the contract amount, the type of project, date completed and your reference contact name, address, email address and telephone number: (SEE ATTACHED SHEET)
Have you ever failed to complete any work awarded to you? ______Yes _____No
Has work ever been completed by performance/payment bond? ______Yes ______No
If “Yes” to either item, specify location and reason:
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the National Park Service with any information needed to verify my capability to perform this project.
Certifying Official Name and Title:
Signature (Sign in Ink):
Date:
PAST EXPERIENCE & REFERENCES
REFERENCES:
This form must be completed by all quoters in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience which is pertinent to this position. Past performance and experience may be a combination of up to two contracts similar in size and complexity to those stated in the Technical Provisions and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training which would enable you to better perform the work outlined in the specifications. Reference information should include a point-of-contact's name, telephone number and e-mail address. (IF
HANDWRITTEN, MUST BE LEGIBLE)
Experience No. 1
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Month/Year work began: Month/Year work ended: ________________________________________
Brief description of duties:
Experience No. 2
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Brief description of duties
Experience No. 3
Contract/Work type: ____________________________________________
Contract Number (if applicable): ____________________________________________
Total Contract Value: __________________________________________
Agency/firm for who work was performed: ____________________________________________
Contact person at the site: Telephone #: ____________________________________________
E-mail address: ____________________________________________
Brief description of duties:
Return form to:
Email: linda_richardson@nps.gov mailto:linda_richardson@nps.gov
Type of Business:
File details come from the government source that posted it. Updated .