Attachment 7 Relevant Experience Questionnaire.pdf
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- Solicitation number
- 12444124R0001
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a past performance questionnaire for federal contractors to provide relevant experience on previous similar contracts. It requests information on the contractor including years of experience, number of years as a prime or subcontractor, and a list of up to five relevant projects completed in the last three years along with contract numbers, award amounts, clients, points of contact, descriptions of work performed, and completion dates. It also asks if the contractor has ever failed to complete work or had work completed by a performance bond. Principal individual experience and credit and banking references are additionally solicited. The related federal contract opportunity is a multiple service maintenance IDIQ for the Savannah River Site in South Carolina issued by the Department of Agriculture Forest Service under solicitation number 12444124R0001.
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Text version
12444124R0001
ATTACHMENT 7
RELEVANT EXPERIENCE (PAST PERFORMANCE) QUESTIONNAIRE
Instructions: See Box 9, remarks, if extra space is needed to answer any item below. Additional sheets may be attached.
1. Contractors Name, Address, Telephone No., & Email
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 RELEVANT PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST
THREE (3) YEARS
NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included.
(i.e., what tasks were performed, (grounds maintenance, erosion control, mulching, forestry work performed, type of equipment used, special safety or requirements) Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Contract Number:______________________________________ Award Amount: _________________________________
Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________
Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________
Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________
Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________
Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________
Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________
Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________
Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________
Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________
Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
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. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
8. Information required to complete a responsibility determination 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. (NOTE: Only POC information is required. Please do NOT provide your account information.)
Company Name/Address Point of Contact Telephone number
9. 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:
File details come from the government source that posted it. Updated .