Exp_Questionaire.doc

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White Pine Pollen Collection, NorthForkand Pierce RD, Nez Perce Clearwater NF
Solicitation number
12034318Q0212
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Experience Questionnaire Form

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Sol_Q0212_VegCollection_SF1449.doc DOC document
WorkersCompForm.docx DOCX document
Copy_of_WP_Pollen_Collection_Location_InfoFY18.xlsx XLSX spreadsheet
Wage_Determination_95-0228.txt TXT text file

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9. Organization and work that will be available for this project:

a. (1) Minimum number of employees:__________ and a (2) Maximum number of employees:__________

b. Are employees regularly on your payroll? _____ Yes _____ No

c. Specify equipment available for this contract:_______________________________________________

Use a separate sheet of paper if necessary.

10. List below the experience of the principal individuals of your business:

Individual’s Name
Present Position
Years of Exp.
Magnitude and Type of Work

11. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above questions):

CERTIFICATION

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 any information needed to verify my capability to perform this project.

12a.Certifying Official’s Name and Title

12b. Signature (Sign in Ink)
13. Date

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