1240LN23Q0073_Experience Questionnaire.pdf
PDF 90 KB Posted
- Solicitation number
- 1240LN23Q0073
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an experience questionnaire for cultural resource surveys for the Dakota Prairie Grasslands being solicited by the USDA Forest Service. The questionnaire collects information on the contractor's experience, past performance, available personnel and equipment to evaluate their ability to conduct surveys of cultural resources. Respondents are asked to provide details on their years of experience in similar work as a prime contractor or subcontractor, completed projects in the last three years where references can confirm experience, any past failures to complete work or need for performance bonds, and descriptions of personnel and equipment available for the project. Principal staff members' names, positions, and experience are also requested.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ 1240LN23Q0073 DPG Cultural Surveys.docx | DOCX document | |
| WD 2015-5381.pdf | ||
| Line Item 001 Maps_McKenzie.pdf | ||
| Line Item 003 Maps_Magpie.pdf | ||
| Line Item 002 Maps_N Tracy Mtn.pdf |
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Text version
USDA Forest Service (1/00)
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 10, Remarks, if extra space is needed to answer any item below. Mark “x” in appropriate boxes.
1. Contractor Name, Address, and Telephone Number
2. Submitted to (Office Name & Address) 3. Business Company Co-Partnership Corporation Individual Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation? __________
5. How many years experience in contracting have you or your business had as a (a) prime contractor ________ and/or (b) sub-contractor ______?
6. List below the projects your business has completed within the last three years (or currently working) where we can confirm that your company has experience in similar work.
Contract Amount
Type of Project Ongoing or
Date Completed
Name, Address, and Telephone No.
of Owner/Person to Contract for
Project Information
7a. Have you ever failed to complete any work awarded to you? _____ Yes _____ No 7b. Has work ever been completed by performance bond? _____ Yes _____ No 7c. If “Yes” to either item 7a or 7b specify location(s) and reason(s) why:
8. 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
9. List below the experience of the principal individuals of your business:
Individual’s Name
And City of Residence Present Position Years of
Exp.
Magnitude and Type of Work
10. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above questions):
11. 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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