A6 Experience Questionnaire.pdf
PDF 576 KB Posted
- Attached to
- TRD Developed Site Carbaryl Application Federal contract opportunity
- Solicitation number
- 127EAV25Q0071
- Issued by
- Department of Agriculture Forest Service
About this file
This Experience Questionnaire is for a TRD Developed Site Carbaryl Application (Solicitation Number 127EAV25Q0071) seeking a contractor to perform insecticide spraying services. The document requires potential contractors to provide detailed information about their qualifications, including California Qualified Applicator License status, years of experience in insecticide spraying, employee availability, progress rates, key personnel qualifications, technical approach, past performance, and current contractual commitments. Contractors must complete sections detailing their company information, references, project history, and provide a certification of the accuracy of their submitted information, with space for a certifying official's signature and date.
The questionnaire aims to comprehensively assess a contractor's capability to perform insecticide application services, requesting specifics such as minimum and maximum employee numbers, equipment and safety plans, past similar projects within the last three years, and ongoing contractual obligations. Potential bidders are expected to demonstrate their expertise, operational capacity, and track record in similar insecticide spraying work, with the goal of determining their suitability for the specific carbaryl application project.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| A6 RFQ 127EAV25Q0071.pdf | ||
| A6 SOI 127EAV25Q0071.xlsx | XLSX spreadsheet | |
| A6 WD 2015-5629 08July25.pdf |
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Text version
Experience Questionnaire TRD Developed Site Carbaryl Application
127EAV25Q0071
1. Contractor Name:
2. POC:
3. Address:
4. Telephone Number:
5. Email Address:
6. UEI:
7. Small Business: Yes/No
2. Do you have a California Qualified Applicator License or Certificate (QAL/QAC)? Yes/No
3. How many years of experience do you or your company have in performing insecticide spraying services?
4. Estimate rate of progress (Such as acres/day, miles/day, or other rate):
Minimum progress rate: Maximum progress rate:
5. Employees that will be available for this work:
a. Minimum number of employees: and Maximum number of employees:
b. Are employees regularly on your payroll? Yes No
6. Please provide references for the last three (3) companies you have performed insecticide service:
Company and Point of Contract Email Address Phone Number
127EAV25Q0071
7. List the name (s) of the key personnel and qualifications who will be performing the insecticide spraying services:
8. Describe technical approach to performing the work – Equipment, safety plan and schedule. (Use another sheet of paper if additional space is needed).
127EAV25Q0071
9. Past Performance - List below the projects your business has completed within the last three (3) years which are similar in scope and scale to this job:
Contract Number Contract Amount Location of Work POC Name, email, phone
Description of Project
Contract Number Contract Amount Location of Work POC Name, email, phone
Description of Project
127EAV25Q0071
Contract Number Contract Amount Location of work POC Name, email, phone
Description of Project
10. List below all of your firm's contractual commitments running concurrently with the work contemplated by this solicitation:
Contract # Dollar Amount Company/Agency Location of work When will the contract be completed?
127EAV25Q0071
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 Government with any information needed to verify my capability to perform this project.
13a. CERTIFYING OFFICIAL'S NAME AND TITLE
13b. SIGNATURE 14. DATE
| POC: |
| Address: |
| Telephone Number: |
| Email Address: |
| UEI: |
| 2 Do you have a California Qualified Applicator License or Certificate QALQAC YesNo: |
| 3 How many years of experience do you or your company have in performing insecticide spraying services: |
| 4 Estimate rate of progress Such as acresday milesday or other rate Minimum progress rate Maximum progress rate: |
| undefined: |
| undefined_2: |
| 5 Employees that will be available for this work: |
| undefined_3: |
| and Maximum number of employees: |
| No: |
| Company and Point of ContractRow1: |
| Email AddressRow1: |
| Phone NumberRow1: |
| Company and Point of ContractRow2: |
| Email AddressRow2: |
| Phone NumberRow2: |
| Company and Point of ContractRow3: |
| Email AddressRow3: |
| Phone NumberRow3: |
| 7 List the name s of the key personnel and qualifications who will be performing the insecticide spraying services: |
| 8 Describe technical approach to performing the work Equipment safety plan and schedule Use another sheet of paper if additional space is needed: |
| Contract NumberRow1: |
| Contract AmountRow1: |
| Location of WorkRow1: |
| POC Name email phoneRow1: |
| Description of Project: |
| Contract NumberRow1_2: |
| Contract AmountRow1_2: |
| Location of WorkRow1_2: |
| POC Name email phoneRow1_2: |
| Description of Project_2: |
| Contract NumberRow1_3: |
| Contract AmountRow1_3: |
| Location of workRow1: |
| POC Name email phoneRow1_3: |
| Description of Project_3: |
| Contract Row1: |
| Dollar AmountRow1: |
| CompanyAgencyRow1: |
| Location of workRow1_2: |
| When will the contract be completedRow1: |
| Contract Row2: |
| Dollar AmountRow2: |
| CompanyAgencyRow2: |
| Location of workRow2: |
| When will the contract be completedRow2: |
| Contract Row3: |
| Dollar AmountRow3: |
| CompanyAgencyRow3: |
| Location of workRow3: |
| When will the contract be completedRow3: |
| Contract Row4: |
| Dollar AmountRow4: |
| CompanyAgencyRow4: |
| Location of workRow4: |
| When will the contract be completedRow4: |
| 14 DATE: |
| Contractor Name: |
| 13a CERTIFYING OFFICIALS NAME AND TITLE: |
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