Attachment_5___Experience_Questionaire.pdf

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)

USDA Forest Service Gifford Pinchot National Forest Northwest Contracting Area (NWCA) 10600 NE 51st Circle Vancouver, WA 98682

3. Business [ ] Company [ ] Corporation [ ] Non-profit Organization [ ] Co-partnership [ ] Individual

4. How many years you or your firm has 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, Telephone No. and email address 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 Amount Of Award

Name, Address, and Telephone No. of Business/Government Agency Involved

Awarded (Units)

Percent Completed

Date Contract 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:

James.Wiltse Text Box

AG-32SD-S-14-0049

James.Wiltse Text Box

- ARS

James.Wiltse Text Box Exterior Facade - HNRC, GF

James.Wiltse Text Box James C. Wiltse, Contracting Officer

USDA-ARS-WBSC

2150 Centre Avenue, Building D, Suite 300 Fort Collins, CO 80526-8119 E-mail: James.Wiltse@ars.usda.gov