127EAT23Q0048 Attachment E Past Performance Questionnaire.pdf
PDF 107 KB Posted
- Attached to
- Honouliuli Estuary Restoration Project Federal contract opportunity
- Solicitation number
- 127EAS23Q0135
- Issued by
- Department of Agriculture Forest Service
About this file
This document is a past performance questionnaire template for a federal solicitation to restore the Honouliuli Estuary in Hawaii. The solicitation is issued by the USDA Forest Service under number 127EAS23Q0135. The questionnaire requests information on the contractor's experience completing similar restoration projects over the last three years, including contract amounts, project details, and references. It also asks if the contractor has ever failed to complete work and requests any additional relevant remarks. Upon completion, the certifying official would sign and date the questionnaire, which is a requirement for the estuary restoration solicitation response due from interested contractors by the Forest Service.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 127EAS23Q0135 Attachment B - Figure 1.pdf | ||
| 127EAS23Q0135 Attachment C - Figure 2.pdf | ||
| 127EAS23Q0135 RFQ Combined SS - Honolulu Estuary Restoration.pdf | ||
| 127EAS23Q0135 Attachment A - Statement of Work (SOW).pdf | ||
| 127EAS23Q0135 Attachment D - Schedule of Items (SOI).pdf |
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Text version
Solicitation 127EAS23Q0135 Honolulu Estuary Restoration
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.
2. SUBMITTED TO (office Name and Address)
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 two (2) projects your business has completed delivering similar equipment within the last three years:
CONTRACT
AMOUNT
TYPE OF PROJECT
DATE
COMPLETED
NAME, ADDRESS, AND TELEPHONE NO. OF
OWNER/PERSON TO CONTACT FOR PROJECT
INFORMATION
7a. Have you ever failed to complete any work awarded to you? Yes No 7b. If “Yes” to Item 8a type of project and reason(s) why:
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
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