Past_Performance_Questionnaire.pdf
PDF 126 KB Posted
- Attached to
- HOFR- JLG LIFT REPAIRS
- Solicitation number
- 140P4525Q0058
About this file
This is a Past Performance Questionnaire form for RFQ 140P4525Q0058 regarding ROVA-HOFR Lift Repair services with the National Park Service. The solicitation number is 0044017250, and the point of contact is Linda Richardson at linda_richardson@nps.gov. The form requires contractors to provide comprehensive information about their business structure, experience, and qualifications, including years of experience in the requested work type, years as prime and subcontractor, and details about any failed contracts or performance bonds.
The questionnaire mandates that contractors list three projects completed within the last five years that are similar to the proposed lift repair services, including contract amounts, project types, completion dates, and reference contacts. For each of the three required experience examples, contractors must provide detailed information including contract/work type, contract numbers, total contract values, agency/firm details, contact person information with phone numbers and email addresses, work duration dates, and comprehensive descriptions of duties performed. The completed form must be submitted to Linda Richardson via email and requires certification by a company official with an ink signature confirming the accuracy of all provided information and authorization for references to provide verification details to the National Park Service.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| A06_T500J_Spec_Sheet.pdf | ||
| B03_WD_2015-5777_SAM.pdf | ||
| Technical_Questionnaire.pdf | ||
| Sol_140P4525Q0058.pdf | ||
| A04_SOW_revised_Towable_Lift_Repairs.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE/REFERENCES
RFQ:140P4525Q0058 – ROVA-HOFR LIFT REPAIR
0044017250
140P4525Q0058 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:
0044017250
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: ____________________________________________
0044017250
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 .