Admendment 0003 Experience Questionaire 14Jan25.pdf
PDF 128 KB Posted
- Solicitation number
- 12445025Q0003
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for solicitation #12445025Q0003 related to SRS HQ Tree Debris Removal services. The form requests detailed information from potential contractors to evaluate their qualifications and capabilities.
The questionnaire requires contractors to provide: business type information, years of experience both as prime and subcontractor, details of up to 3 most relevant projects completed within the past 3 years, current contract commitments, organizational information including employee counts and equipment availability, estimated progress rates for tree debris removal work, experience of key personnel, credit references, and banking information. The form also asks about any history of failed contracts or performance bond completions. Contractors must certify all statements as complete and correct, and authorize the Forest Service to verify their capability to perform the project through provided references. The document appears to be Amendment 0003 to the solicitation, dated January 2025.
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Text version
Solicitation No: 12445025Q0003 SRS HQ Tree Debris Removal
NAME, ADDRESS, E-MAIL, & PHONE NO. TO
CONTACT FOR INFORMATION.
AWARD
AMOUNT
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
Company Co-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
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
NUMBER
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 specify location(s) and reason(s) why
PERCENT
Solicitation No: 12445025Q0003 SRS HQ Tree Debris Removal
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 .