4. Experience Questionnaire.docx
DOCX document 38 KB Posted
- Attached to
- GAOA SOUTH ZONE FENCE REPLACEMENT Federal contract opportunity
- Solicitation number
- 1240LT26Q0016
- Issued by
- Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form issued by the USDA Forest Service for contractors bidding on the GAOA South Zone Fence Replacement project (Solicitation 1240LT26Q0016). The questionnaire requires prospective contractors to provide detailed information about their qualifications and capacity to complete fencing work on the Manti La Sal National Forest.
The form requests essential contractor information including company name, business structure, and contact details, along with demonstrated experience in demolition and installation of barbed wire fencing, wooden rail fencing, and lay-down fencing completed within the past three years. Respondents must document at least five completed projects (sections 6.A through 6.E) with specific details about how they followed specifications, disposed of materials, managed work in areas without power and water, adapted when heavy machinery was unavailable, maintained site security while keeping areas open to the public, handled challenging terrain such as timber and marshland, and provided warranties and handled deficiencies. The form also requires documentation of concurrent contractual commitments, employee availability (minimum and maximum headcount), equipment inventory, and progress rate estimates. Additional sections address whether the contractor has ever failed to complete awarded work or required performance bonds, confirmation of on-site project visits, and detailed experience of principal individuals involved. Responses must be certified by an authorized official, and respondents should reference Box 11 (Remarks) for elaboration on any items. Completed questionnaires should be submitted to Tony Taylor at tony.taylor@usda.gov.
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, Remarks, if extra space is needed to answer any item below, Mark “X: in appropriate boxes.
1. Contractor Name, Address, and Telephone Number, SAM UEI
2. Submitted to (Office Name and Address) Tony Taylor – tony.taylor@usda.gov
| 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’ experience have you or your business had as a (a) prime contractor and/or (b) sub-contractor ?
6. List below the projects that include the demolition and installation of barb wire fencing, wooden rail fencing, and lay down fencing your business has completed within the last three years. Highlight the following factors in the Type of Project Section: Comment by Taylor, Tony - FS, KY: Box 11. on page three may be used to elaborate. Identify in box 11 which project is being elaborated on.
Ex: 6. A - This project was challenging because…
6. B - This project was temporarily closed to the public only while equipment was on site...
· Include how your business was able to follow diagrams and specifications if any were present.
· Include how the materials were disposed of.
· Explain how you were able to perform in settings that did not have power and water readily available.
· Describe your process for when heavy machinery could not be used in the project area.
· Explain how you were able to keep the area secure but still open for use.
· Describe what you did in challenging project areas such as heavy timber, marsh land, boulder fields, and other challenging settings.
· Explain the warranty and guarantees for previous projects and how you handled deficiencies if any were present.
| Box # |
| Contract Amount |
| Type of Project |
| Date Completed |
| Name, Address, and Telephone No. of Owner/Person to Contact for Project Information |
6. A
6. B
6. C
6. D
6. E
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation. Explain how you have kept in contact with the entity over the contract. What were the communication methods? How did you ensure that the product is what was wanted. How was the project inspected. How have you handled disputes if any?
| Contract Number |
| Dollar Amt. of Award |
| Name, Address, and Telephone No. of Business/Government Agency Involved |
| Awarded (Units) |
| Percent Completed |
| Date Contract Complete |
8a. Have you ever failed to complete any work awarded to you? ☐ Yes ☐ No 8b. Has work ever been completed by performance bond? ☐ Yes ☐ No 8c. Did you look at the project site(s) on-the-ground? ☐ Yes ☐ No 8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: and (2) Maximum number of employees:
b. Are employees regularly on your payroll: ☐ Yes ☐ No
c. Specify equipment available for this contract:
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate: and (2) Maximum progress rate:
10. List below the experience of the principal individuals of your business: (Who will directly be involved in this contract?)
| Individual’s Name |
| Present Position |
| Years of Experience |
| Magnitude and Type of Work |
11. Remarks -- Specify Box Numbers (This box will extend as information is added to accommodate extra space.):
NOTE: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT WILL HELP EVALUATE YOUR ABILITY TO SUCCESSFULLY COMPLETE THIS PROJECT.
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.
12a. CERTIFYING OFFICIAL’S NAME AND TITLE
| b. SIGNATURE (Sign in ink) |
| 13. DATE |
File details come from the government source that posted it. Updated .