1202SC24Q2700 Amend001 Attachment 4 Experience Questionnaire.docx
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- Solicitation number
- 1202SC24Q2700
- Issued by
-
Department of Agriculture Forest Service
About this file
This Experience Questionnaire requests information from offerors for Solicitation 1202SC24Q2700 issued by the Department of Agriculture Forest Service. The solicitation seeks proposals for laundry services to support the Northwest Area Incident Support Cache at the Redmond Air Center in Redmond, Oregon. Offerors are asked to provide details of relevant past experience from the last three years, including project locations, contract numbers, award amounts, periods of performance, client references, and descriptions of services performed. Additional information may be requested from apparent successful offerors to complete a responsibility determination, including credit references, banking information, and any remarks.
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EXPERIENCE QUESTIONNAIRE
Instructions: See Box 8, remarks, if extra space is needed to answer any items below. Additional sheets may be attached.
| 1. Contractors Name, Address & Telephone No. |
| 2. Type of Business |
__ Company __ Co-Partner __ Non-profit
__ Corporation __ Individual
3. How many years’ experience do you have in this line of work ___ Yrs
4. How many years’ experience as a prime contractor ___ subcontractor ___
5. LIST OF PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST 3 YEARS
Note: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e Capability statement must demonstrate clearly the understanding that this is a fire related; summary should include information on the proposed facilities, address quality control, and any proposed methodologies as to how you plan to provide the commercial services listed herein and your understanding that the estimated quantities and amount of services required are based on the variable nature of fire and other natural disasters, that cannot be predicted nor assured. List the services performed and quantities involved (articles/each) and any other types of services or other similar work accomplished).
Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Project Location: ________________________________________________________________________
Contract Number: _________________________ Award Amount: $________________
Period of Performance and/or Completion Date: __________________________________
Client/Company’s Name/Address: __________________________________________________________
Contact Name, Email and Telephone Number: ________________________________________________
Description of Services (Refer to Note in No. 5): _______________________________________________
Project Location: _________________________________________________________________________
Contract Number: _________________________ Award Amount: $___________________
Period of Performance and/or Completion Date: _____________________________________________
Client/Company’s Name/Address: __________________________________________________________
Contact Name, Email and Telephone Number: _______________________________________
Description of Services (Refer to Note in No. 5): _______________________________________________
Project Location: ________________________________________________________________
Contract Number: _________________________ Award Amount: $___________________
Period of Performance and/or Completion Date: ______________________________________
Client/Company’s Name/Address: _________________________________________________
Contact Name, Email and Telephone Number: _______________________________________
Description of Services (Refer to Note in No. 5): ______________________________________
6a. Have you ever failed to complete any work awarded to you? __ Yes __ No
6b. Has work ever been completed by performance bond? __ Yes __ No
6c If “Yes” to either item 6a or 6b specify location(s) and reason(s) why
7. Information required to complete a responsibility determination. If necessary, of the apparent successful offeror. (Additional information may be requested once a contractor is selected for award. Moreover, contractor might need to provide additional authorization from a creditor to grant access.)
a. Credit References.
| Company Name/Address |
| Point of Contact |
| Telephone Number |
| Materials/Services Provided |
b. Banking Information.
| Name/Address |
| Point of Contact |
| Telephone Number |
| Account Number |
8. REMARKS (Additional sheets may be attached to the experience questionnaire)
CERTIFCATION: 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 Forest Service with information needed to verify my capability to perform this project.
| Name: |
| Title: |
| Date: |
Attachment 4 - Solicitation 1202SC24Q2700 – Laundry Services – Redmond Air Center (RAC)
File details come from the government source that posted it. Updated .