Atth_7_Experience_Questionnaire.doc

DOC document 84 KB Posted

Attached to
Coffee Pot #2 Bridge Construction Federal contract opportunity
Solicitation number
1282D718R0006
Issued by
Department of Agriculture Forest Service R2-Rocky Mountain Region

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Attachment 7 Experience Questionnaire

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Other files for this federal contract opportunity

Other files attached to Coffee Pot #2 Bridge Construction, newest first.
File Type Posted
Coffee_Pot_Pre-Bid_QA.pdf PDF
Atth_5_Performance_Bond_SF25-16a.pdf PDF
Atth_3_DOL_Wage_CO13_and_CO23.pdf PDF
Atth_1_Section_C_Specifications.pdf PDF
Atth_4_Payment_Bond_SF25A-16a.pdf PDF
Coffee_Pot_Bridge_B-M_Clauses.pdf PDF
Atth_2_Coffee_Pot_PSE_plans-stamped.pdf PDF
Atth_6_Bid_Bond_SF24.pdf PDF

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Text version

Solicitation No.: 1282D718R0006

Coffee Pot Bridge Replacement White River National Forest

EXPERIENCE QUESTIONNAIRE

1. CONTRACTOR NAME, ADDRESS AMD PHONE#

2. SUBMITTED TO (Office Name & Address)

USDA Forest Service White River National Forest 900 Grand Ave Glenwood Springs, CO 81601

3. BUSINESS:

___ Company ___ Co-partnership ___ Corporation ___ Individual __ Non-profit Organization

4. How many years of experience do you or your firm have in the line of work contemplated by this solicitation?

5. HOW MANY YEARS EXPERIENCE IN CONTRACTING HAVE YOU OR YOUR FIRM HAD AS A:

PRIME CONTRACTOR

AND/OR 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, & PHONE OF OWNER PERSONS TO CONTACT FOR PROJECT INFORMATION

7. LIST BELOW ALL OF YOUR CONTRACTUAL COMMITMENTS RUNNING CONCURRENTLY WITH THE

WORK CONTEMPLATED BY THIS PROJECT:

CONTRACT NUMBER
AMOUNT

OF AWARD

NAME, ADDRESS & PHONE # OF

BUSINESS/GOVERNMENT AGENCY INVOLVED

AWARDED (UNITS)
PERCENT COMPLETED
DATE COMPLETED

8. (A) DESCRIBE A SITUATION WHERE THE CONTRACT PERFORMANCE PERIOD WAS NOT MET AND HOW IT WAS RESOLVED.

(B) DESCRIBE A SITUATION WHERE A PRICE CHANGE TO A CONTRACT WAS REQUESTED AND HOW IT WAS RESOLVED.

(C) DESCRIBE A SITUATION WHERE A WARRANTY ISSUE WAS RAISED BY THE OWNER AND HOW IT WAS RESOLVED.

(D) DESCRIBE A SITUATION WHERE A PROBLEM WAS ENCOUNTERED AND ANY CORRECTIVE ACTIONS TAKEN TO PREVENT A RECURRENCE.

9. LIST BELOW THE EXPERIENCE OF THE PRINCIPAL INDIVIDUALS OF YOUR BUSINESS:

INDIVIDUAL'S NAME
PRESENT POSITION
YEARS OF EXP.
MAGNITUDE AND TYPE OF WORK

10. REMARKS: SPECIFY BOX NUMBERS (Attach sheets if extra space is needed to fully answer any of the above questions):

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.

11a. CERTIFING OFFICIAL'S NAME AND TITLE

11 b. SIGNATURE (Sign in Black Ink)
12. DATE

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