Attachment 5 Exp Questionnaire.pdf
PDF 37 KB Posted
- Attached to
- USFS Commercial Garage Door Repair Boulder RD
- Solicitation number
- 1240LP26Q0103
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a USDA Forest Service Experience Questionnaire, a standard form used to evaluate contractor qualifications and capability for federal forestry contracts.
The questionnaire requires contractors to provide comprehensive information about their business experience and capacity to perform work. Key sections include: contractor identification and business type classification (company, corporation, co-partnership, individual, or non-profit organization); years of experience in the relevant line of work and distinction between prime contractor and sub-contractor experience; project completion history within the last three years, including contract amounts, project types, completion dates, and reference contact information; and current contractual commitments running concurrently with the solicited work, including contract numbers, dollar amounts, units awarded, percent completion, and contract completion dates. The form also addresses project performance history, specifically whether the contractor has failed to complete awarded work, required performance bonds, and whether the contractor inspected project sites on-the-ground. Sections nine and ten address resource availability, requiring disclosure of minimum and maximum employee counts, payroll status, available equipment, estimated progress rates (such as acres per man-day), and detailed information about principal individuals directly involved in contract execution, including their names, present positions, years of experience, and types of work experience. The form concludes with a certification section in which the certifying official attests under penalty of perjury that all statements are complete and correct and authorizes reference checks by the Forest Service.
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Other files
| File | Type | Posted |
|---|---|---|
| Updated 1240LP26Q0103 Garage Door Repair Solicitation.pdf | ||
| 1240LP26Q0103 Garage Door Repair Solicitation.pdf | ||
| Attachment 3 Pictures of Garage Doors.pdf | ||
| Attachment 4 Certificate of Conformance.docx | DOCX document | |
| Attachment 6 15-5415 Wage Determination Boulder County.txt | TXT text file | |
| Attachment 1 Statement of Work.pdf | ||
| Attachment 2 Schedule of Items.xlsx | XLSX spreadsheet |
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, 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 and 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 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:
Contract Amount
Type of Project Date Completed
Name, Address, and Telephone No. of Owner/Person to Contact for Project Information
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
Number
Dollar Amt.
of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date
Complete
8a. Have you ever failed to complete any work awarded to you? [ ] Yes [ ] No 8b. Has work ever been completed by performance bond? [ ] Yes [ ] No 8c. Did you look at the project site(s) on-the-ground? [ ] Yes [ ] No 8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (2) Maximum number of employees: _____
b. Are employees regularly on your payroll: [ ] Yes [ ] No
c. Specify equipment available for this contract:______________________________________________________
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate:________________ and (2) Maximum progress rate: _________________________
10. List below the experience of the principal individuals of your business. (Who will directly be involved in this contract?)
Individual’s Name Present Position Years of Experience
Magnitude and Type of Work
11. Remarks -- Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question.):
NOTE: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT WILL HELP EVALUATE YOUR ABILITY TO
SUCCESSFULLY COMPLETE THIS PROJECT.
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
b. SIGNATURE (Sign in ink) 13. DATE
File details come from the government source that posted it. Updated .