4. Experience Questionnaire.docx
DOCX document 38 KB Posted
- Attached to
- LUCERNE CAMPGROUND CONSTRUCTION PHASE 5 Federal contract opportunity
- Solicitation number
- 1240LT26Q0026
- Issued by
- Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form used by the USDA Forest Service to evaluate contractor qualifications for the Lucerne Campground Construction Phase 5 project (Solicitation 1240LT26Q0026). Contractors must provide comprehensive information about their experience, capacity, and past performance to demonstrate capability to complete the proposed work.
The questionnaire requires contractors to document years of experience in the relevant line of work, specify experience as prime and sub-contractors, and detail specific projects completed within the last three years involving demolition and reconstruction of similar facilities. Critical areas of experience evaluation include removal and disposal of existing buildings such as standalone restrooms and sidewalks, construction of shelters and windscreen fencing, installation of pre-cast concrete restroom buildings, sidewalk construction, signage installation, finish grading, electrical service connections, irrigation system installation with electrical control wiring, and asphalt trench repair work. Contractors must also list concurrent contractual commitments, explain communication and inspection methods, disclose any work failures or performance bond completions, confirm on-site project visits, and identify available employees and equipment with estimated progress rates. Principal individuals directly involved in the contract must be identified with their experience and work magnitude. Submission should be directed to Tony Taylor at tony.taylor@usda.gov. The form includes certification requirements affirming the accuracy and completeness of all statements provided. Additional remarks addressing evaluation criteria should be provided in Box 11 to support the contractor's capability assessment.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1.1 Solicitation Terms and Conditions Amendment 001.pdf | ||
| 3.1 SOI - Lucerne Amendment 001.pdf | ||
| FAR 52.222-90 Amendment 001.pdf | ||
| 2.1 Statement of Work Addition Amendment 001.pdf | ||
| Questions-Answers Amendment 001.pdf | ||
| Site Visit Attendance - Amendment 001.pdf | ||
| 5. Drawings.pdf | ||
| 0. Quote -Checklist.docx | DOCX document | |
| 1. Solicitation Terms and Conditions.pdf | ||
| 3. SOI - Lucerne.pdf | ||
| 7. Davis-Bacon Act WD - UT20260079.pdf | ||
| 2. Statement of Work.pdf | ||
| 6. Supplemental Drawings Existing Irrigation.pdf |
Show all 13
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 reconstruction of facilities similar to those listed in the SOW that 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 - Excess material was properly disposed on this project by …
6. B - The requirements in this project’s specifications were met by ensuring ...
· Tell how you removed and properly disposed of existing buildings similar to standalone restrooms and sidewalks.
· Include your experience constructing shelters, windscreen fencing, and installation of pre-cast concrete restrooms buildings or similar.
· Include your experience constructing sidewalks, installing signs, finish grading, and installing new electrical service connections.
· Include your experience installing irrigation systems including electrical control wiring.
· Include your experience with asphalt trench repair.
· Explain your Ability to meet past project requirements according to provided specifications.
| 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 .