A6. A3_Past Performance Questionnaire.docx
DOCX document 48 KB Posted
- Solicitation number
- 127EAS26Q0012
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Past Performance Questionnaire form (FS-6300-27) required by the USDA Forest Service for the solicitation 127EAS26Q0012 regarding Eldorado National Forest FY26 Container Planting Mix supply. The form must be submitted to Klenise Wallace at klenise.wallace@usda.gov and requests comprehensive information about the bidding company's qualifications and experience relevant to this procurement.
The questionnaire requires companies to provide: company information and business type classification; years of experience in the relevant line of work and as prime or sub-contractors; up to five completed projects from the past five years with detailed information including project title, role (prime or sub-contractor), contract number, total value, award date, completion status, and project point of contact details; disclosure of any work failures or performance bond completions with explanations; confirmation of on-site project inspection; staffing availability with minimum and maximum employee counts; and regular payroll status. The form must be certified by an authorized official with signature and date. This questionnaire serves as a critical evaluation tool for the Forest Service to assess the bidder's past performance capability and suitability for the small business set-aside solicitation, which has a response deadline of March 5, 2026 at 1500 PT for the supply of 80/20 peat moss-vermiculite soil mix in tote bags to be delivered to Placerville Nursery in Camino, California.
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Other files
| File | Type | Posted |
|---|---|---|
| A7-1. A4_Reps and Certs_FILLABLE.docx | DOCX document | |
| A7-1. A1_SF30&TERMS_127EAS26Q0012.pdf | ||
| A6. A4_Reps and Certs_FILLABLE.docx | DOCX document | |
| A6. A1_SF1449&Terms_127EAS26Q0012.pdf | ||
| A6. A2_SOI_127EAS26Q0012.xlsx | XLSX spreadsheet |
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Text version
United States Department of Agriculture
Forest Service
Rocky Mountain Acquisition Management
2150 Centre Ave., Bldg. E Fort Collins, CO 80526
| United States Department of Agriculture |
| Forest Service (FS) |
| Procurement and Property Services (PPS) |
Past Performance Questionnaire
| 1. Company Information |
| Submit To: |
Company Name:
Address:
Telephone No.:
USDA Forest Service ATTN: Klenise Wallace Email: klenise.wallace@usda.gov
| Solicitation No. |
| 127EAS26Q0012 |
2. Business Type: ☐ Company ☐ Co-partnership ☐ Corporation ☐ Individual ☐ Non-Profit Organization
3. How many years do you or your firm have in the line of work contemplated by this solicitation?
| 4. How many years of experience in contracting have you or your business had as a |
| (4a) prime contractor |
and/or
(4b) sub-contractor
5. List below, a maximum of five (5) projects your firm has completed relating to this solicitation within the last five (5) years:
(5a) PROJECT DETAILS
Project Title
Role: ☐ Prime ☐ Sub-contractor
| Contract No. |
| Total Value (Dollar Amt) |
| Award Date |
| Complete? |
☐ YES Date
| Project Summary |
| Percent Complete |
Company/Government Entity Name Contracted by
Address
POC Telephone
POC Name
POC Email
Project Title
Role: ☐ Prime ☐ Sub-contractor
| Contract No. |
| Total Value (Dollar Amt) |
| Award Date |
| Anticipated Completion Date |
| Project Summary |
| Percent Complete |
Company/Government Entity Name Contracted by
Address
POC Telephone
POC Name
POC Email
Project Title
Role: ☐ Prime ☐ Sub-contractor
| Contract No. |
| Total Value (Dollar Amt) |
| Award Date |
| Anticipated Completion Date |
| Project Summary |
| Percent Complete |
Company/Government Entity Name Contracted by
Address
POC Telephone
POC Name
POC Email
Project Title
Role: ☐ Prime ☐ Sub-contractor
| Contract No. |
| Total Value (Dollar Amt) |
| Award Date |
| Anticipated Completion Date |
| Project Summary |
| Percent Complete |
Company/Government Entity Name Contracted by
Address
POC Telephone
POC Name
POC Email
Project Title
Role: ☐ Prime ☐ Sub-contractor
| Contract No. |
| Total Value (Dollar Amt) |
| Award Date |
| Anticipated Completion Date |
| Project Summary |
| Percent Complete |
Company/Government Entity Name Contracted by
Address
POC Telephone
POC Name
POC Email
| 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 |
6c. If “Yes” to either item 8a or 8b specify location(s) and reason(s) why:
| 6d. Did you look at the project site(s) on-the-ground? |
| ☐ Yes ☐ No |
| 7a. Organization and work that will be available for this project. |
| (1) Minimum No. of Employees: |
(2) Maximum No. of Employees:
| 7b. Are employees regularly on your payroll: |
| ☐ Yes ☐ No |
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’s name as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
8a. CERTIFYING OFFICIAL’S NAME AND TITLE
| 8b. SIGNATURE (Sign in ink) |
| 8c. DATE |
Previous edition is obsolete Page 1 of 3 FS-6300-27 (3/00) image1.jpeg
File details come from the government source that posted it. Updated .