12363N23Q4039 ATTACHMENT 4 Experience Questionnaire.pdf

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Attached to
Chequamegon-Nicolet National Forest Brush Saw Treatment
Solicitation number
12363N23Q4039
Issued by

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Other files

File Type Posted
12363N23Q4039 ATTACHMENT 1 Statement of Work.pdf PDF
12363N23Q4039 ATTACHMENT 2 MAPS.pdf PDF
12363N23Q4039 ATTACHMENT 5 SCA WD 1981-1253 WAGE DETERMINATION.pdf PDF
12636N23Q4039 ATTACHMENT 3 PRICING SCHEDULE EXHIBIT.pdf PDF
12363N23Q4039 Combined_Synopsis_Solicitation_ Brush Saw Treatment.docx DOCX document

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Solicitation No: 12363N23Q4039 Brush Saw Treatment -Chequamegon-Nicolet Forest

Attachment 4

EXPERIENCE QUESTIONNAIRE

Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.

1. Contractors Name, Address & Telephone No. Email 2. Type of Business Company Co-Partner Non-profit

Corporation Individual

3. How many years of experience do you have in this line of work Yrs.?

4. How many years of experience as a prime contractor/subcontractor?

5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:

CONTRACT

NUMBER

AWARD

AMOUNT

NAME, ADDRESS, E-MAIL, &

PHONE NO. TO CONTACT

FOR INFORMATION.

DATE

CONTRACT

COMPLETED

DESCRIPTION OF

WORK PERFORMED

6. List all your firm’s current contract commitments

CONTRACT

NUMBER

AWARD

AMOUNT

NAME, ADDRESS, E-MAIL, & PHONE NO. TO

CONTACT FOR INFORMATION.

PERCENT

7a. Have you ever failed to complete any work awarded to you? Yes or No

7b. Has work ever been completed by performance bond? Yes or No

7c. If "yes" to either item 7a or 7b specify location(s) and reason(s) why

Solicitation No: 12363N23Q4039 Brush Saw Treatment -Chequamegon-Nicolet Forest

Attachment 4

8. Organization information available for this project:

a. Minimum # of employees: and Maximum # of employees:

b. Are employees regularly on your payroll: yes no

c. Specify equipment available for this contract:

d. Estimate rate of progress (such as 2.0 acres per day):

1. Minimum progress rate: Maximum progress rate

9. List the experience of the principal individuals of your business

INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK

10. Information required to complete a responsibility determination if the apparent successful offeror.

a. Credit References Company Name/Address Point of Contact Telephone number TYPE OF WORK

b. Banking Information.

Company Name/Address Point of Contact Telephone number TYPE OF WORK

11. REMARKS

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:

Name: Title: Date:

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