ATTACHMENT 6 - Relevant Experience Questionaire.doc
DOC document 82 KB Posted
- Attached to
- NFSR 29-0. 0 Road Construction Project (Amendment 2) Federal contract opportunity
- Solicitation number
- 12467020R0064
About this file
This document contains a relevant experience questionnaire and details of a federal contract opportunity for road construction services. The relevant experience questionnaire requests information on the contractor's qualifications, including years of experience, past projects of similar scope completed within the last three years, references, experience of principal staff, and financial information.
The federal contract opportunity is for road construction services located in Florida. Work includes erosion control, culvert installation, roadbed work, excavation, clearing and grubbing, and seeding and mulching. The period of performance is 120 days after notice to proceed. The project value is between $500,000 and $1,000,000. Payment and performance bonds are required, as is a bid guarantee. The solicitation will be available on June 3, 2020. This is a 100% total small business set aside for the Department of Agriculture Forest Service Southern Region. There is no incumbent.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 2 to 12467020R0064 Site Visit Minutes.pdf | ||
| Amendment 2 to 12467020R0064 SF-30.pdf | ||
| Amendment 2 to 12467020R0064 Sign In Sheet.PDF | ||
| Amendment 1 to 12467020R0064 SF-30.pdf | ||
| Amendment 1 to 12467020R0064 SF1442.pdf | ||
| ATTACHMENT 4 - Specifications FSSS.pdf | ||
| ATTACHMENT 2 - Statement of Work_ OCA NFSR 29-0.0 (1).docx | DOCX document | |
| ATTACHMENT 3 - Planset Drawings_ OCA ERFO NFSR 29-0.0 (1).pdf | ||
| ATTACHMENT 1 - Schedule of Items.xlsx | XLSX spreadsheet | |
| ATTACHMENT 5 - DOL Wage Determination Marion Co FL20200176.pdf | ||
| 12467020R0064 SF1442.pdf | ||
| 12467020R0064 Solicitation Body.doc | DOC document |
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Text version
AG-4670-S-16-0117
ATTACHMENT 5
RELATIVE EXPERIENCE QUESTIONNAIRE
12467020R0064
ATTACHMENT 6
RELEVANT EXPERIENCE 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 7a or 7b 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 .