Atch_5_-_Pre-Award_Survey.pdf
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- Attached to
- Repairs of Bldg. 362 at Sierra Army Depot (SIAD)
- Solicitation number
- W91238-17-R-0032
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Atch 5 - Pre-Award Survey
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Pre-Award Survey of Prospective Contractors
CONSTRUCTION CONTRACTOR DATA DATE:
Firm Name and Telephone Number Main Office Address (Street, City, and State)
Branch Offices Services Rendered � Construction � Design � Consultant
Organization � Individual � Joint Venture � Partnership � Corporation
Date Organized Date Incorporated:
State:
Names of Officers and Other Key Personnel
I – PRESENT PAYROLL PERSONNEL (List Number of Each Category Below) Partners:
Officers:
Other Key:
Remainder: Subtotal Permanent:
Maximum Personnel at Any Time:
Date:
Total:
II—EQUIPMENT OWNED III—FINANCIAL DATA AS OF
(DATE): Present Value ($) Current Assets:
Acquisition Cost ($) Current Liabilities:
Net Worth:
IV—TOTAL VALUE OF CONSTRUCTION AND DEMOLITION
WORK IN PAST 6 YRS EXCLUSIVE OF JOINT VENTURE
(LIST MOST RECENT FIRST)
V—LARGEST JOB EVER
CONTRACTED
(If Other Than in Past Six Years)
$ LARGEST JOB IN PAST 6 YRS Contract Amount:
Date:
Description:
Owner:
$ Contract Amount:
Date:
Description:
Owner:
Avg. Annual Income
VI—TYPE OF WORK IN WHICH FIRM SPECIALIZES
NAME AND POSITION/TITLE OF PERSON SIGNING
SIGNATURE
� See attachment for explanations or detailed description of item(s) reported above.
CONSTRUCTION CONTRACTOR DATA – SCHEDULE A – EXISTING COMMITMENTS
List below the construction projects your firm currently has under way, including recent awards. Also list construction projects for which your firm is the apparent successful offeror/bidder, but for which a contract has not yet been awarded.
CONTRACT
NUMBER
AMOUNT
DESCRIPTION/
LOCATION
ORGANIZATION/
CONTACT PERSON/
PHONE NUMBER
PERCENT
COMPLETE
CONSTRUCTION CONTRACTOR DATA – SCHEDULE B – COMPLETED PROJECTS
List below the principal construction projects your firm has completed within the past six years, including all DoD contracts.
NUMBER
AMOUNT
DESCRIPTION/
LOCATION
ORGANIZATION/
CONTACT PERSON/
PHONE NUMBER
PERCENT
SUBLET
CONSTRUCTION CONTRACTOR DATA – SCHEDULE C –
CONSTRUCTION AND/OR TECHNICAL EQUIPMENT
List total equipment and facilities owned for performing the prospective contract and present status as to whether or not it is currently committed to existing contracts.
QUANTITY
DESCRIPTION
CONDITION
YEARS OF
SERVICE
PRESENT
STATUS
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