4. Experience Questionnaire.docx
DOCX document 18 KB Posted
- Attached to
- Long Horse NNIS at Hoosier National Forest
- Solicitation number
- 12444525Q0045
- Issued by
-
Department of Agriculture Forest Service
About this file
The document is an Experience Questionnaire for a federal contract opportunity with the Department of Agriculture Forest Service, specifically for the Long Horse Non-Native Invasive Species (NNIS) project at Hoosier National Forest. The questionnaire requests detailed information from potential contractors, including business type, years of experience, past project history, current contract commitments, organizational structure, employee details, and key personnel qualifications.
The form requires contractors to provide comprehensive information such as the number of years of experience as a prime or subcontractor, a list of similar completed projects in the last three years, current contract commitments, and details about project personnel. Specific requirements include hand-held GPS and shapefile experience, and the contractor must describe their work plan for accomplishing the task. The project involves herbicide treatment of non-native invasive species following timber harvest to increase tree regeneration and reduce hazardous fuels. Contractors must certify the accuracy of their submitted information and provide their Tax Identification Number (TIN) and DUNS number.
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| File | Type | Posted |
|---|---|---|
| 3. Wage Determination SCA 2015-4821.pdf | ||
| 1. Performance Work Statement.pdf | ||
| 2. Maps.pdf | ||
| Sol OM-RFQ_12444525Q0045.pdf |
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Text version
EXPERIENCE QUESTIONNAIRE
1. Contractor’s Name, Address & Telephone #.
2. Type of Business
___Company ___Co-Partner ___Corporation ___Individual ___Non-profit Organization
| 3. How many years experience do you have related to this line of work? _______ years |
| 4. How many years experience as a prime contractor? ________years |
Subcontractor? _______
5. List all the similar projects your business has completed in the last three (3) years.
| CONTRACT AMOUNT |
| TYPE OF CONTRACT WORK |
| DATE COMPLETED |
| Contact Name, Address and Tele. # |
6. List all of your firms’ current contract commitments
| CONTRACT NUMBER |
| AWARD AMOUNT |
| Contact Name, Address & Tele. # |
| Percent Completed |
| Date Contract Completed |
| 7a. Have you ever failed to complete any work awarded to you? | ___yes | ___no | ||
| 7b. Has work ever been completed by performance bond? | ___yes | ___no |
7c. If “yes” to either item 7a or 7b above, specify reason(s) and location(s) why.
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: _____ | and Maximum No. of employees:_____ | ||
| b. Are employees regularly on your payroll? | ___yes | ___no |
c. Specify equipment to be used for this contract:
d. Estimate rate of progress (exp. 100 feet, 1/8 mile a day, etc…):
Progress Rate of _______________
9. List the experience of the principal individuals of your business tied to this project
| NAME |
| PRESENT POSITION |
| YRS EXP. |
| TYPE OF WORK |
10. Hand Held GPS and Shapefile experience, And/or Avenza Experience:
11. Work plan: Describe plan how to accomplish task.
TIN#__________________ Duns#_______________ CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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.
| __________________________ | ___________________________ | ___________________ | ______ | ||
| Signature | Print or Typed Name | Title | Date |
File details come from the government source that posted it. Updated .