Attachment 3. Experience Questionaire.pdf
PDF 158 KB Posted
- Attached to
- Salvage Removal Services Federal contract opportunity
- Solicitation number
- 12441923Q0180
- Issued by
- Department of Agriculture Forest Service
About this file
This document contains an experience questionnaire for contractors to complete in response to Solicitation Number 12441923Q0180 issued by the Department of Agriculture Forest Service for salvage removal services. The experience questionnaire requests information on the contractor's experience including three past projects with details on location, contract number, award amount, period of performance, client references, and descriptions of services performed. It also asks whether the contractor has ever failed to complete work or had work completed by a performance bond. The contractor must provide credit and banking references and certify that statements made in the questionnaire are complete and correct.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 5. Updated Questions & Responses.pdf | ||
| 12441923Q0180-0001.pdf | ||
| Attachment 4. Questions Responses_.pdf | ||
| Attachment 1. Updated SOW Dated September 8, 2023.pdf | ||
| 12441923Q0180.pdf | ||
| Attachment 1. Statement of Work.pdf | ||
| Attachment 2. Wage Rates WD#2015-5197.pdf | ||
| Attachment 2. Experience Questionaire.pdf |
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Text version
Attachment 2 - Page 1 of 2
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____Yrs
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.
manual forestry service, manual and mechanical applications, mastication/chipping.) List the services performed and quantities involved (Quantity/Acreage) and any other types of forestry support services 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 grounds maintenance, cleaning services performed, 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 grounds maintenance, cleaning services performed, 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 grounds maintenance, cleaning services performed, etc.)
Attachment 3 - Page 2 of 2
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 Provided
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:
ATTACHMENT 3 –Experience Questionnaire
File details come from the government source that posted it. Updated .