Attachment_4__-_EXPERIENCE_QUESTIONAIRE.pdf
PDF 192 KB Posted
- Attached to
- CONECUH NATIONAL FOREST FISHING PIERS
- Solicitation number
- 12414619Q0014
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Experience Questionnaire
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment_5_-_PAST_PERFORMANCE_QUESTIONAIRE.pdf | ||
| SOL_12414619Q0014.pdf | ||
| 12414619Q0014__1442.pdf | ||
| Vicinity_Maps.pdf |
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12414619R0004, Talladega Ranger District Roof Replacements, Attachment 3 - Page 1 of 2 District Office & Pesticide Building
ATTACHMENT 3 –EXPERIENCE QUESTIONNAIRE
Instructions: See Box 8, remarks, if extra space is needed to answer any item below. Additional sheets may be attached.
1. Contractors Name, Address & Telephone No. 2. Type of Business Company Co-Partner Non-profit Corporation Individual
3. How many years experience do you have in this line of work Years
4. How many years experience as a prime contractor subcontractor
5. LIST OF PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST 3 YEARS
NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e. roof removal, replacement of sheathing, metal roof installation.) List the services performed and quantities involved (miles, linear feet) and any other types of resurfacing, subgrade repair or other similar work accomplished).
Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Project & Location
Contract Number: Award Amount:
Period of Performance and/or completion date:
Client/Company’s Name/Address:
Contact Name, email and Telephone number:
Description of Services (refer to note in No. 5 type of roof removal, replacement of sheathing, metal roof installation etc.)
Project & Location
Contract Number: Award Amount:
Period of Performance and/or completion date:
Client/Company’s Name/Address:
Description of Services (refer to note in No. 5 type of roof removal, replacement of sheathing, metal roof installation, etc.)
Project & Location
Contract Number: Award Amount:
Period of Performance and/or completion date:
Client/Company’s Name/Address:
Contact Name, email and Telephone number:
Description of Services (refer to note in No. 5 type of roof removal, replacement of sheathing, metal roof installation, etc.)
12414619R0004, Talladega Ranger District Roof Replacements, Attachment 3 - Page 2 of 2 District Office & Pesticide Building
6a. Have you ever failed to complete any work awarded to you? yes no
6b. Has work ever been completed by performance bond? yes __ no
6. If "yes" to either item 6a or 6b specify location(s) and reason(s) why
7. Information required to complete a responsibility determination, if necessary, of the apparent successful offeror. (Additional information may be requested once a contractor is selected for award. Moreover, the contractor might need to provide additional authorization from a creditor to grant access.)
a. Credit References
Company Name/Address Point of Contact Telephone number Materials/Services Provid ed
b. Banking Information.
Company Name/Address Point of Contact Telephone number Account No.
8. REMARKS (Additional sheets may be attached to the experience questionnaire)
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:
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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