Past_Performance_Questionnaire.pdf
PDF 127 KB Posted
- Attached to
- WORI REPLACE ELEVATOR CONTROLS Federal contract opportunity
- Solicitation number
- 140P4525Q0063
About this file
This document is a Past Performance Questionnaire for a Request for Quote (RFQ) by the National Park Service for a Passenger Elevator Control Replacement project, identified by solicitation number 140P4525Q0063. The questionnaire requires potential contractors to provide detailed information about their past experience, including three previous projects completed within the last five years that are similar in size and complexity to the requested service. Contractors must document contract/work type, total contract value, agency/firm details, contact information, work dates, and a brief description of duties for each project experience.
The form also requires contractors to disclose their business type, years of experience in the requested work type, and contracting history as a prime or sub-contractor. Respondents must certify the accuracy of their statements and indicate whether they have ever failed to complete awarded work or had work completed through a performance/payment bond. The point of contact for this solicitation is Linda Richardson, who can be reached at linda_richardson@nps.gov, and completed forms should be returned to this email address.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140P4525Q0063_Amd_0001.pdf | ||
| B03_WD_2015-4181_SENECA_CTY_SAM.pdf | ||
| Technical_Questionnaire.pdf | ||
| Sol_140P4525Q0063.pdf | ||
| A04_WORI_Elevator_Control_Replacement_SOW_Final.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE/REFERENCES
RFQ:140P4525Q0063 – WORI – PASSENGER ELEVATOR CONTROL REPLACEMENT
0044013074
140P4525Q0063 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 .