CONSTRUCTION_CONTRACTOR_EXPERIENCE_DATA.docx
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- Refueling Vehicle Repair Shop, Little Rock Air Force Base (LRAFB), Jacksonville, Pulaski County, Arkansas
- Solicitation number
- W9127S-16-R-6001
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Construction Contractor Experience Data Pre-Award Survey Information
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CONSTRUCTION CONTRACTOR EXPERIENCE DATA
PRE-AWARDY SURVEY INFORMATION
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 5 YRS EXCLUSIVE OF JOINT VENTURE
(LIST MOST RECENT FIRST)
V—LARGEST JOB EVER CONTRACTED
(If Other Than in Past Five Years)
| $ |
| LARGEST JOB IN PAST 5 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 |
NOTE: Use reverse side for explanations or detailed description of item(s) reported above.
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