A6_A3. PastPerfQuest127EAS26Q0010.pdf
PDF 719 KB Posted
- Solicitation number
- 127EAS26Q0010
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Past Performance Questionnaire form used by the USDA Forest Service for contract evaluation purposes, specifically for solicitation 127EAS26Q0010 regarding an ENF Placerville Nursery CON-FY26 Wax Box (Supply) Purchase. The form is designed to collect contractor historical performance data and experience information to assess bidder qualifications.
The questionnaire requires contractors to provide their company name, address, and telephone number; identify their business structure (company, corporation, co-partnership, individual, or non-profit organization); and document their years of experience in the relevant line of work and contracting history as both prime and subcontractors. Contractors must list projects completed within the last three to five years, including contract amounts, project types, completion dates, and owner/contact information for reference verification. Additionally, the form requires disclosure of any failure to complete previously awarded work, with explanation of circumstances if applicable. The contractor must certify under penalty that all statements are complete and correct to the best of their knowledge and authorize the Forest Service to verify capability through named references. The completed form should be submitted to Klenise Wallace at the USDA Forest Service via email at klenise.wallace@usda.gov.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| A7-1_A5. Photos of Wax Boxes.pdf | ||
| A7-1_A6. Drawing, Wax boxes 2026.pdf | ||
| A7. A1_SF30&Terms_127EAS26Q0010-0001.pdf | ||
| A7-1_A2. SOI_127EAS26Q0010-0001.xlsx | XLSX spreadsheet | |
| A6_A1. SF1449&Terms, 127EAS26Q0010.pdf | ||
| A6_A2. SOI_127EAS26Q0010.xlsx | XLSX spreadsheet | |
| A6_A4. Reps and Certs_FILLABLE.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
USDA – Forest Service
PAST PERFORMANCE QUESTIONNAIRE
(Ref. FSH 6309.31 and 41 USC 1)
INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.
1. CONTRACTOR NAME, ADDRESS, AND TELEPHONE NO.
3. BUSINESS
Company Co-partnership Corporation Individual Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years of experience in contracting have you or your business had as a (a) prime contractor and/or (b) sub-contractor _________?
6. List below the projects your business has completed within the last three to five years:
CONTRACT
AMOUNT TYPE OF PROJECT
DATE
COMPLETED
NAME, ADDRESS, AND TELEPHONE NO. OF
OWNER/PERSON TO CONTACT FOR PROJECT
INFORMATION
Yes No 7b. 7a. Have you ever failed to complete any work awarded to you?
If “Yes” to Item 8a type of project and reason(s) why in the spaces below:
8. Remarks. Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question):
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any person named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
9a. CERTIFYING OFFICIAL’S NAME AND TITLE
b. SIGNATURE (Sign in ink) 10. DATE
2. SUBMITTED TO (office Name and Address) USDA Forest Service Attn: klenise.wallace@usda.gov Email: klenise.wallace@usda.gov
127EAS26Q0010 - ENF Placerville Nursery CON-FY26 Wax Box (Supply) Purchase
| 1 CONTRACTOR NAME ADDRESS AND TELEPHONE NO: |
| Company: Off |
| Corporation: Off |
| Nonprofit Organization: Off |
| Copartnership: Off |
| Individual: Off |
| 4 How many years do you or your firm have in the line of work contemplated by this solicitation: |
| CONTRACT AMOUNTRow1: |
| TYPE OF PROJECTRow1: |
| DATE COMPLETEDRow1: |
| NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow1: |
| CONTRACT AMOUNTRow2: |
| TYPE OF PROJECTRow2: |
| DATE COMPLETEDRow2: |
| NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow2: |
| CONTRACT AMOUNTRow3: |
| TYPE OF PROJECTRow3: |
| DATE COMPLETEDRow3: |
| NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow3: |
| CONTRACT AMOUNTRow4: |
| TYPE OF PROJECTRow4: |
| DATE COMPLETEDRow4: |
| NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow4: |
| CONTRACT AMOUNTRow5: |
| TYPE OF PROJECTRow5: |
| DATE COMPLETEDRow5: |
| NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow5: |
| 7a Have you ever failed to complete any work awarded to you Yes No 7b If Yes to Item 8a type of project and reasons whyRow1: |
| 7a Have you ever failed to complete any work awarded to you Yes No 7b If Yes to Item 8a type of project and reasons whyRow2: |
| 8 Remarks Specify Box Numbers Attach sheets if extra space is needed to fully answer any above question: |
| 9a CERTIFYING OFFICIALS NAME AND TITLE: |
| 10 DATE: |
| Text2: |
| 7b: Off |
File details come from the government source that posted it. Updated .