Experience Questionnaire.pdf
PDF 351 KB Posted
- Attached to
- Ashland RD Bldg. 1000 remodel Federal contract opportunity
- Solicitation number
- 1240LU24Q0035
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an EXPERIENCE QUESTIONNAIRE from the USDA Forest Service, which is used to gather information about a contractor's past experience and capabilities. The questionnaire asks the contractor to provide details such as the number of years in the line of work, experience as a prime or subcontractor, a list of completed projects, and any issues with completing past work. It also requests information on the contractor's organization, personnel, and equipment available for the project. The contractor must certify that the information provided is accurate.
The related federal contract opportunity is for siding, insulation, and window replacements on a residence at the Ashland Ranger District in Montana, with an estimated value between $25,000 and $100,000. The contractor is required to fill out the 1442 form with the schedule of items in Section B, including an optional item, and to provide the completed Experience Questionnaire as part of the response.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1240LU24Q0035 Amendment 1.pdf | ||
| 1240LU24Q0035 Ashland Bldg 1000 remodel.pdf | ||
| Ashland Bldg 1000 figures.pdf | ||
| Wage determinations mt6.pdf | ||
| Ashland Bldg 1000 Supplemental Specifiactions.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 Contact 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:
Forest Service PPS 1019 N 5th St Custer, SD 57730
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
File details come from the government source that posted it. Updated .