JANITORIAL_experience_questionnaire_rfq.doc

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Attached to
BITTERROOT NF DARBY RANGER DISTRICT JANITORIAL SERVICES Federal contract opportunity
Solicitation number
AG-03R6-S-17-0023
Issued by
Department of Agriculture Forest Service R1-Northern Region

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Experience Questionnaire to be completed and submitted with offer

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Other files attached to BITTERROOT NF DARBY RANGER DISTRICT JANITORIAL SERVICES, newest first.
File Type Posted
Q_+_A_No_2.docx DOCX document
DOLWage_Determination_2015-5402_Rev1_Dated_01252017.pdf PDF
darby_janitorial_solicitation_2017.pdf PDF
Q_+_A_No_1.pdf PDF
2017_Darby_Att_B_Schedule_of_Items.pdf PDF
Wage_Determination_2015-5402_Rev1.pdf PDF

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USDA Forest Service

JANITORIAL SERVICES 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 janitorial services?

5. How many years experience have you or your business had as a (a) prime contractor ____ and/or (b) sub-contractor ____ in janitorial services?

6. List below the janitorial service projects your business has completed within the last three years:

CONTRACT AMOUNT
TYPE OF PROJECT
DATE COMPLETED
NAME, ADDRESS & TELEPHONE # 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:

CONTRACT NUMBER
DOLLAR AMT. OF AWARD
NAME, ADDRESS, AND TELEPHONE NO. OF BUSINESS/GOVERNMENT AGENCY INVOLVED
AWARDED (UNITS)
PERCENT COMPLETE
DATE CONTRACT COMPLETED

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. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:

(OVER)

9. Organization and work that will be available for this project:

a. (1) Minimum number of janitorial employees: _____ and a (2) Maximum number of janitorial employees: _____?

b. Are janitorial employees regularly on your payroll: [ ] Yes [ ] No

c. Specify janitorial 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: _________________________

INDIVIDUAL’S NAME
PRESENT POSITION
YEARS OF JANITORIAL 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 t 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

10. List below the experience of the principal individuals of your business: (Who will directly be involved in this contract?)

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