127EAT26Q0006 Attachment 3 -Past Performance Questionnaire.pdf
PDF 49 KB Posted
- Attached to
- LA Gateway Janitorial Federal contract opportunity
- Solicitation number
- 127EAY26Q0006
- Issued by
- Department of Agriculture Forest Service
About this file
This document is a USDA – Forest Service Past Performance Questionnaire, a form designed to collect detailed information about a contractor's business experience and previous project history. The questionnaire requires contractors to provide information about their business type (company, co-partnership, corporation, individual, or non-profit), years of experience in the relevant work, and a list of completed projects within the last three years. Key sections include documenting contract amounts, project types, completion dates, and contact information for references. The form also includes a certification section where the contractor affirms the accuracy of the provided information and authorizes the Forest Service to verify their capability to perform the proposed project.
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Text version
USDA – Forest Service
PAST PERFORMANCE QUESTIONNAIRE
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 the projects your business has completed 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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