A04.Attachment 5- ExpQ.pdf
PDF 37 KB Posted
- Attached to
- Rifle Ranger District- Janitorial Services Federal contract opportunity
- Solicitation number
- 1240LP26Q0071
- Issued by
- Department of Agriculture Forest Service
About this file
This is a USDA Forest Service Experience Questionnaire used to evaluate a contractor's qualifications and capability to perform a solicited project.
The questionnaire requests comprehensive information about the contractor's background and resources. Contractors must provide their business information and type (company, corporation, co-partnership, individual, or non-profit organization), along with years of experience in the relevant line of work and experience as prime or sub-contractors. Section 6 requires listing of projects completed within the last three years, including contract amounts, project types, completion dates, and owner contact information. Section 7 requires disclosure of all concurrent contractual commitments, including contract numbers, award amounts, percent completion, and expected completion dates. The form also requires responses to questions regarding failure to complete work, performance bond completion, and on-the-ground site visits. Section 9 addresses available resources, including minimum and maximum employee counts, payroll status, equipment specifications, and estimated rates of progress. Section 10 requests details on principal individuals directly involved in the contract, including their names, positions, years of experience, and work magnitude and type. Section 11 provides space for additional remarks and clarifying information. The form concludes with a certification statement requiring the certifying official's signature, title, and date, confirming the accuracy and completeness of all statements provided.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions and Answers.pdf | ||
| C05.1240LP26Q0071-Rifle RD Janitorial Services.pdf | ||
| A04.Attachment 3- Rifle RD Building layout.pdf | ||
| A04.Attachment 1- Schedule of Items.xlsx | XLSX spreadsheet | |
| A04.Attachment 2-Rifle Janitorial FY26 PWS.pdf | ||
| C05.Attachment 4-WD 2015-5439 rev 28 dated 12-3-2025.pdf |
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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
2. Submitted to (Office Name and Address)
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 your business has completed within the last three years:
Contract Amount
Type of Project Date Completed
Name, Address, and Telephone No. of Owner/Person to Contact for Project Information
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
Number
Dollar Amt.
of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date
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 (Attach sheets if extra space is needed to fully answer any above question.):
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
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