7. Contractor-Questionnaire_Tech-Eval.pdf
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- Solicitation number
- 12445224B0009
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire, which is an attachment to Solicitation No. 12445224B0009 for 2024 Road Maintenance in the Nantahala Ranger District.
The Questionnaire requests information about the contractor's business type, years of experience, similar projects completed, current contract commitments, equipment and personnel resources, progress rates, planning and scheduling, and safety measures. It also requires the contractor to provide credit references and banking information. This information will be used to evaluate the contractor's relevant past performance and experience.
The related federal contract opportunity is for road maintenance services on National Forest roads within the Nantahala, Cheoah, and Tusquitee Ranger Districts of the Nantahala National Forest. The period of performance is 90 days. No pre-bid site visit will be held. The contractor must provide all equipment, labor, and materials necessary to perform the work in accordance with the Performance Work Statement specifications.
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Text version
ATTACHMENT 7 SOLICITATION No. 12445224B0009
2024 ROAD MAINTENANCE
NANTAHALA RANGER DISTRICT
Page 1 of 4 Attachment Number
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address, Telephone No. & Email
2. Type of Business ___Company ___Co-Partner ___Non-profit
___Corporation ___Individual
3. Howmany years experience do you have in this line of work? ____________Years
4. How many years experience as a Prime Contractor___________ Subcontractor____________
5. List three to five similar projects completed in the last 5 years.
CONTRACT
NUMBER
AWARD
AMOUNT
NAME ADDRESS & PHONE
NO. TO CONTACT FOR INFO.
PERCENT
COMPLETED
DATE CONTRACT
COMPLETED
6. List all of your firms current contract commitments
CONTRACT
NUMBER
AWARD
AMOUNT
NAME ADDRESS & PHONE NO. TO CONTACT
FOR INFO.
PERCENT
COMPLETED
Page 2 of 4 Attachment Number
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
7. If "yes" to either item 7a or 7b specify location(s) and reason(s) why
8. Organization information available for this project:
a. Minimum # of employees: ____________ and Maximum # of employees: ______________
b. Are employees regularly on your payroll: ___yes __ _no
c. Specify equipment available for this contract:
1. Motorgrader:
Whay type of motorgrader is planned for this solicitation? _____________________________________________
Is this motorgrader owned, leased or subcontracted? __________________________________________________
What size of motorgrader? Please state the horsepower, weight and blade width. ___________________________
2. What type of equipment is going to be used to clean culverts and tail ditches? _____________________________
3. How many dump trucks will be used/obtained to support aggregate hauling and spreading operations to National Forest System Roads: __________________________________________________________________________
Are these dump trucks owned, leased or subcontracted? _______________________________________________
What size are these dump trucks? Please state the # of axles and hauling capacities in tons. __________________
d. Estimate rate of progress: (Miles per Day)
1. Blading: Minimum progress rate: ____________ Maximum progress rate: ____________
2. Ditching: Minimum progress rate: ____________ Maximum progress rate: ____________
3. Cleaning Culverts and Tail Ditches : Minimum progress rate: __________ Maximum progress rate: __________
Estimate rate of progress: (Tons per Day)
4. Spot Surfacing: Minimum progress rate: ______________ Maximum progress rate: ________________
Page 3 of 4 Attachment Number
e. Planning & Scheduling:
1. How do you intend to plan scheduling for other concurent projects listed in box 6.
f. Site Visit:
1. Have you visited the site and are you familiar with the work to be performed, condition of the roads, site accessibility, etc… to ensure succesful execution of all contract requirements at the quoted unit prices?
Please explain.
g. Safety & Traffic Control
1. Please explain the safety measures that you will put in place to ensure that site specific safety hazards have been considered adequate mitigation measures are in place for those hazards.
9. List the experience of the principal individuals of your business that will be used to perform this solicitation:
(Such as, motorgrader operator, other equipment operators, site superintendant, etc…)
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. Information required to complete a responsibility determination if the apparent successful offeror.
a. Credit References
Company Name/Address Point of Contact Telephone number TYPE OF WORK
b. Banking Information.
Company Name/Address Point of Contact Telephone number TYPE OF WORK
Page 4 of 4 Attachment Number
11. REMARKS
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:
Name:
Title: Date:
Technical Evaluation Factors are:
• 1. Relevant Past Performance/Experience Quetionaire
• 2. Price
File details come from the government source that posted it. Updated .