Attachment 2 - Construction Contractor Experience Data.docx
DOCX document 26 KB Posted
- Attached to
- 115 FW Construct Alert GOV Parking Shelter
- Solicitation number
- W50S9F26BA011
- Issued by
-
Department of the Army National Guard
About this file
This is a Construction Contractor Experience Data form required for submission with bids or quotes for solicitation W50S9F26BA011 regarding the construction of Alert Government Owned Vehicle (GOV) Parking Shelters at the 115th Fighter Wing, Truax Field, Madison, Wisconsin.
The form collects comprehensive financial and operational information from construction contractors to demonstrate their capability and experience. Required data includes firm identification (name, address, branch offices, and organizational structure); current payroll personnel by category; equipment owned and to be used on the project; financial data as of a specified date (current assets, current liabilities, net worth, and present/acquisition values); annual receipts for the preceding six years as reported to the IRS; and details on the largest job ever contracted, including the largest job completed in the past six years with contract amounts and descriptions. Contractors must also provide information on recent government contracts performed, including the contracting agency, date, description, contract amount, contract type, and signature of the authorized company representative. The form allows space on the reverse side for remarks, explanations, or detailed descriptions. Per the form instructions, data obtained from this pre-award survey shall not be released outside of the Government.
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Text version
CONSTRUCTION CONTRACTOR EXPERIENCE DATA
IFB/RFP NO: W50S9F26BA011
Project: XGFG182006 – Alert GOV Parking Shelter Date:
1. Firm Name
2. Main Office Address (Street, City, State, Zip and Telephone)
3. Branch Offices
4. Organization _Individual Partnership _Joint Venture Corporation
5. Date Organized
6. Date Incorporated and State
7. Names of Officers and Other Key Personnel:
I - PRESENT PAYROLL PERSONNEL (List Number of Each Category Below)
Partners
Officers
Other Key
Remainder
Total
Subtotal Permanent
Maximum Personnel at Any Time
Date
Equipment to be Used in Performance of Subject Project:
| II - EQUIPMENT OWNED |
| III - FINANCIAL DATA AS OF (Date) |
Present Value ($)
Acquisition Cost ($)
Current Assets ($)
Current Liabilities ($)
Net Worth ($)
IV - ANNUAL RECEIPTS OF THIS CONCERN AND AFFILIATES FOR THE PRECEDING SIX YEARS
(As Reported to IRS)
V - LARGEST JOB EVER CONTRACTED
(If Other Than in Past Six Years)
| 2025 | $ |
| Largest Job in Past Six Years | |
| Contract Amount ($) |
Date
| 2024 | $ |
| Contract Amount ($) |
Date
2023 $
Description
| 2022 $ |
| Description |
2021 $
2020 $
Average:
Owner
Owner
RECENT GOVERNMENT CONTRACTS PERFORMED
| Agency |
| Date |
| Description |
| Amount |
| Type Name and Position or Title of Person Signing |
| Signature |
Note 1. Data obtained from this pre-award survey shall not be released outside of the Government
Note 2. Use reverse side for remarks, explanations, or detailed description of item reported above
File details come from the government source that posted it. Updated .