C04d_Exhibit A Performance Relevancy Questionnaire_12444026Q0189.pdf
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- Solicitation number
- 12444026Q0189
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Exhibit A Performance Relevancy Questionnaire used by the U.S. Forest Service to evaluate contractor capability and past performance on federal contracts. The questionnaire requires offerors to demonstrate relevant experience by providing detailed information about their firm's background, prior projects, and current commitments.
Offerors must provide their contractor name, address, and telephone number, along with the number of years of experience in the relevant line of work and years of experience as both prime and subcontractors. The questionnaire requires submission of up to five projects completed within the last three years that are similar in scope to the solicitation, including contract amounts, project types, completion dates, and contact information for project references. Offerors must also list all concurrent contractual commitments, including contract numbers, dollar amounts, awarding agencies, percentage completed, and expected completion dates. The form requires certification of whether the firm has ever failed to complete awarded work or had work completed via performance bond, with explanations required if applicable. For Part 2, offerors must provide detailed responses on separate sheets addressing the specific work elements performed by their firm, subcontractor involvement, technical relevance to the solicitation, and points of contact from the government agency or owner, including current phone numbers, facsimile numbers, and email addresses. The document concludes with a certification section requiring the signature of an authorized official in ink, affirming the accuracy and completeness of all statements.
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Text version
Exhibit A: PERFORMANCE RELEVANCY QUESTIONNAIRE
Provide the following information requested in this format for each of the projects/contracts being described. Projects may be ongoing and cannot have been completed any later than 3 years prior to the to this issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. Use as much space as required. OFFEROR SHOULD PLACE
THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE.
INSTRUCTIONS: If extra space is needed use the reverse. Mark "X" in appropriate boxes.
CONTRACTOR NAME, ADDRESS & TELEPHONE
How many years do you or your firm have in the line of work contemplated by this solicitation ? How many years’ experience in contracting have you or your business had as a (a) prime contractor and/or (b) sub-contractor ?
PART 1 - PAST / CURRENT PROJECTS
List below up to 5 projects your business has completed within the last 3 years similar in scope to the solicitation:
Contract Amount Type of Project Date Completed Name Address & Telephone No. of Person to Contact for Project Information.
List below all of your firm's contractual commitments running concurrently with the work contemplated by this solicitation:
Contract No. Dollar Amount of Project
Name, Address & Phone No. of Business Govt./Agency
Awarded (Units)
Completed
Date Contract Completed
Have you ever failed to complete any work awarded to you? Yes ( ) No ( ) Has work ever been completed by performance bond? Yes ( ) No ( ) If "Yes" to either item above specify location(s) and reason(s) why:
PART 2 – SPECIALIZED EXPERIENCE – For each of the projects listed above, address the following comments on a separate sheet:
a) Describe the specific elements of the work performed by your firm.
b) Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on Forest Service projects.
c) Address any technical areas about this project you consider uniquely relevant to this solicitation.
d) Point of Contact for Owner/Government agency Contracting Officer and or inspector; include a current phone number and facsimile number. Email address is also desired.
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.
Certifying Official's Printed Name and Title Signature (In Ink) Date
File details come from the government source that posted it. Updated .