Optional_Response_Form.rtf

Optional Response Forms

EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE

Instructions: See Box 10, REMARKS, if extra space is needed to answer any items below. Mark "X" in the appropriate spaces. Please list N/A for inapplicable items.

1. Offeror's Name, Address, Email, Telephone Number & DUNS Number

2. Type of Business Name:

____ Company ____ Partnership ____ Individual/ Sole Proprietor Address:

Email:

Telephone:

DUNS #:

How many years of experience do you have in this line of work?

Describe your experience performing janitorial services (or the experience of the person who you are proposing as janitor)

List similar projects or contracts your business has performed (preference for recent) Contract Name Facility Type/Size Service Dates Description of Services Performed

List up to three references for whom your business has performed relevant work (same projects as above preferred; others acceptable) Contact Name(s) Company Name Project Performed Contact Phone Number(s)

Janitorial Services will be provided by (check one):

The Contractor (self) and/or the Contractor’s business partner (partnership)

An employee or employees of the Contractor

A subcontractor or subcontractors of the Contractor

Optional Comments / Other Information:

Certification Statement: By submitting this form, I certify that all of the statements made above 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. (No signature necessary)