Attachment 5 Pre Award Survey.pdf

Attachment 5 Pre-Award Survey

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 $

Pre-Award Survey

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.

The completed Construction Contractor Data Form with Supplemental Schedules A-C (see format which follows). If the offeror is a large multi- segmented business concerns, the data provided on the supplemental schedules may be limited to information that directly pertains to the specific segment of the business concern (e.g., the division, group, unit, etc.) proposed to perform work under the prospective contract with its own work force. If the offer is being submitted by a Joint Venture, submit a separate form for each Joint Venture participant. The offeror may submit pre-award survey information in another format, provided that the information furnished is substantially the same as that which would be furnished on the Construction Contractor Data Form and its supplemental schedules.

Current financial statements. If the financial statement is more than 60 days old, submit a certificate stating that the firm's financial condition is substantially the same, or, if not the same, state the changes that have taken place. If a

Joint Venture, provide this information for each participant in the Joint Venture.

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

DESCRIPTION/

ORGANIZATION/

PERCENT

NUMBER AMOUNT LOCATION CONTACT COMPLETE

PERSON/

PHONE NUMBER

Banking information. Provide letters from banks or other financial institutions with which the contractor conducts business. The letters should contain information about your firm's accounts, loans, lines of credit, etc. The

Government is interested in financial stability, timely payments, the length and nature of the relationship between the firm and the financial institution, and the firm's financial ability to perform the contract. The letters should also provide the name and telephone number of the bank representative the Government may contact. If a Joint Venture, provide this information for each Joint Venture participant.

The Government will treat the pre-award survey information submitted by the offeror as proprietary

CONSTRUCTION CONTRACTOR DATA – SCHEDULE B – COMPLETED PROJECTS

List below the principal construction projects your firm has completed within the past five 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