J-2_Experience_Questionnaire.pdf

Experience and Past Performance Questionnaire

Provide information on your experience performing this requirement. Briefly describe what you did, where, when, and who was the customer. There is no time limit on experience.

Provide present/past performance information on relevant contracts performed within the last three years for Federal agencies and commercial customers.

Relevant contracts are contracts where you performed: forest road decommissioning, construction or repair.

Provide the information requested in this form for each contract being described.

Provide frank, concise comments regarding your performance on the contracts you identify. If more space is required, continue on the back of the form or on one continuation sheet.

A. Offeror name (Company/Division):

B. Product/Service:

C. Contract Specifics:

1. Contract Number: _________________________________________

2. Contract Type: ___________________________________________

3. Original Contract $ Value: __________________________________

4. Current Contract $ Value: ___________________________________

5. If Amounts for 3 and 4 above are different, provide a brief description of the reason:

D. Completion Date:

1. Original Completion Date: ___________________________________

2. Actual Completion Date: ____________________________________

3. How many times completion date changed: _____________________

4. Primary Causes of Completion Date change:

E. Verified Primary Customer Points of Contact: (Please provide current information on both individuals)

Technical Contracting Officer

Name: _____________________________ ________________________

Office: _____________________________ _______________________

Address _____________________________ ________________________

Telephone _____________________________ ________________________

F. Brief Description of Effort as ___ Prime or ___Subcontractor:

G. Highlight portions considered most relevant to current acquisition, including similar problems/risks that were encountered. Provide comments regarding compliance with contract terms and conditions, and any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions.