Past_Performance_Questionnaire.pdf

PDF 137 KB Posted

Attached to
EDIS - Conserve West Bedroom Rug Federal contract opportunity
Solicitation number
140P4526Q0006
Issued by
Department of the Interior National Park Service

About this file

This is a Past Performance Questionnaire and References form for RFQ 140P4526Q0006 issued by the National Park Service for the EDIS Conserve West Bedroom Rug procurement. The point of contact is Roselyn Sessoms at roselyn_sessoms@nps.gov.

All quoters must complete this form to receive consideration. The questionnaire requires contractors to provide company information including business type (company, co-partnership, corporation, individual, or non-profit organization), years of experience in the type of work requested, and years of experience as a prime contractor and/or subcontractor. Contractors must list three projects completed within the last five years that are similar in size and complexity to the solicitation requirements, including contract amount, project type, completion date, and detailed reference contact information (name, address, email, and telephone number). The form also requires disclosure of any failures to complete awarded work and whether work was completed under performance or payment bond, with explanations if applicable. A certification statement must be signed by an authorized official attesting to the accuracy and completeness of all statements. Reference information must be legible if handwritten. Completed forms should be returned via email to roselyn_sessoms@nps.gov.

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Sol_140P4526Q0006_Amd_0001.pdf PDF
B03_2015-4211_rev_32_12032025.pdf PDF
Technical_Questionnaire.docx DOCX document
Sol_140P4526Q0006.pdf PDF
B08_Contractor_Monitoring_SOP_Revised_5-10-22_(F)_(1).pdf PDF
Price_Schedule_WEST_BEDROOM_RUG.xls XLS spreadsheet
A04_RFPWestBedroomRug.pdf PDF

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Text version

PAST PERFORMANCE QUESTIONNAIRE/REFERENCES

RFQ:140P4526Q0006 – EDIS – CONSERVE WEST BEDROOM RUG

POINT OF CONTACT: ROSELYN SESSOMS, roselyn_sessoms@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

Brief description of duties

Experience No. 3

Brief description of duties:

Return form to:

Email: roselyn_sessoms@nps.gov

File details come from the government source that posted it. Updated .