12444524Q0095 - Experience and Past Performance Questionnaire.docx
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- Solicitation number
- 12444524Q0095
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Experience and Past Performance Questionnaire related to a federal contract opportunity for Goat livestock grazing of woody vegetation through the targeted grazing method.
The key details are:
- This is a Request for Quotation (RFQ) issued by the U.S. Department of Agriculture Forest Service for commercial services, anticipated to result in multiple firm fixed-price, indefinite delivery/indefinite quantity (IDIQ) contracts with a 5-year ordering period.
- The contract is a 100% small business set-aside under NAICS code 112420 Goat Farming, with a $2.5M average annual receipts size standard.
- The questionnaire collects information on the contractor's business type, years of experience, past projects, current commitments, equipment and personnel capacity, and key personnel experience.
- The contractor must be registered in the System for Award Management (SAM) and not debarred from federal contracting. The Service Contract Act wage determination applies.
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Text version
EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE
Instructions: Use Item No. 10 Remarks if extra space is needed to answer any item below. Answer all items.
1. Contractor’s Name, Address & Telephone Number.
1. Type of Business
___Company ___Co-Partner ___Corporation ___Individual ___Non-profit Organization
| 3. How many years’ experience do you have in this Line of work? ____ Years |
| 4. How many years’ experience as a Prime Contractor? _____ Years |
Subcontractor? _____ Years
5. List the projects your business has completed in the last three (3) years.
| COMPANY NAME, ADDRESS , TELEPHONE NUMBER AND CONTACT PERSON |
| CONTRACT TYPE/PROJECT DESCRIPTION |
| CONTRACT AMOUNT |
| PERIOD OF PERFORMANCE/DATE COMPLETED |
1. List all of your firms’ current contract commitments.
| CONTRACT NUMBER |
| AWARD AMOUNT |
| Contact Name, Address & Telephone Number |
| Percent Completed |
| Date Contract Completed |
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 above, specify reason(s) and location(s) why.
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: _____ | and Maximum No. of employees: _____ | ||
| b. Are employees regularly on your payroll? | ___Yes | ___No |
1. Specify equipment available for this contract:
1. Estimate rate of progress (exp. 100 feet, 1/8 mile a day, etc…):
Minimum progress rate: ____________ Maximum progress rate: ____________
9. List the experience of the principal individuals of your business
| NAME |
| PRESENT POSITION |
| YEARS EXPERIENCE |
| TYPE OF WORK |
10. REMARKS
CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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.
| __________________________ | ___________________________ | ___________________ | ______ | ||
| Signature | Print or Typed Name | Title | Date |
Duns # _______________ Tax ID# ______________ Currently Registered in SAM? [ ] Yes or [ ] No
File details come from the government source that posted it. Updated .