12445023Q0004_Attach_5_Experience_Questionnaire.docx

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Attached to
Coweeta Janitorial Services Federal contract opportunity
Solicitation number
12445023Q0004
Issued by
Department of Agriculture Forest Service

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File Type Posted
(REVISED)12445023Q0004_Attach_4_SCLS _Wage_Determination_27Dec22.pdf PDF
Solicitation 12445023Q0004_QA_18Jan22.pdf PDF
12445023Q0004 _Attach_3_Pricing Exhibit_28Dec22.xlsx XLSX spreadsheet
12445023Q0004_Attach_2_Diagrams_of_Coweeta_Buildings.pdf PDF
12445023Q0004_Combined_Synopsis_Solicitation_Coweeta_Janitorial_28Dec22.pdf PDF
12445023Q0004_Attach_4_SCLS _Wage_Determination_27Jun22.pdf PDF
12445023Q0004_Attach_1_Performance_Work_Statement_28Dec22.pdf PDF

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EXPERIENCE QUESTIONNAIRE

Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.

1. Contractors Name, Address & Telephone No. Email
2. Type of Business
CompanyCo-Partner Non-profit

Corporation Individual

3. How many years of experience do you have in this line of work Yrs.?

4. How many years of experience as a prime contractor/subcontractor?

5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:

CONTRACT NUMBER
AWARD AMOUNT
NAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.
DATE CONTRACT COMPLETED
DESCRIPTION OF WORK PERFORMED

6. List all your firm’s current contract commitments

CONTRACT NUMBER
AWARD AMOUNT
NAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.
PERCENT

7a. Have you ever failed to complete any work awarded to you? Yes or No 7b. Has work ever been completed by performance bond? Yes or No

7c. If "yes" to either item 7a or 7b specify location(s) and reason(s) why Solicitation

No:

1244502 3Q0004

Coweeta Janitorial Services Attachment

8. Organization information available for this project:

a. Minimum # of employees: and Maximum # of employees:

b. Are employees regularly on your payroll: yes no

c. Specify equipment available for this contract:

d. Estimate rate of progress (such as 2.0 acres per day):

1. Minimum progress rate: Maximum progress rate

9. List the experience of the principal individuals of your business

INDIVIDUALS NAME
PRESENT POSITION
YRS EXP
TYPE OF WORK

10. Information required to complete a responsibility determination if the apparent successful offeror.

a. Credit References

Company Name/Address
Point of Contact
Telephone number
TYPE OF WORK

b. Banking Information.

Company Name/Address
Point of Contact
Telephone number
TYPE OF WORK

11. REMARKS

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 .