AG-3604-S-17-0010_AMEND_000002.pdf

AG-3604-S-17-0010

EXPERIENCE QUESTIONNAIRE Contractor name, address, phone, & email:

ATTACHMENT C

1. Submitted to: (Office Name & Address) 3. Business:

__Company ___Co-partnership __Corporation ___Individual __Non-profit Organization

4. How many years does your firm have in the line of work described in this solicitation?

5. HOW MANY YEARS EXPERIENCE IN CONTRACTING HAVE YOU OR YOUR FIRM HAD AS A:

PRIME CONTRACTOR_________________ AND/OR SUB-CONTRACTOR_____________

6. LIST BELOW THE PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST THREE YEARS:

CONTRACT

AMOUNT $

TYPE OF PROJECT /

Project description

DATE

COMPLETED

NAME, ADDRESS, EMAIL, PHONE, & PERSON TO CONTACT FOR PROJECT

INFORMATION:

AMENDMENT 000002

7. LIST BELOW ALL OF YOUR CONTRACTUAL COMMITMENTS RUNNING CONCURRENTLY WITH THE

WORK CONTEMPLATED BY THIS PROJECT: Will your designated crew leader (s) be involved in these commitments?

CONTRACT

NUMBER

AMOUNT

OF AWARD

NAME, ADDRESS, EMAIL & PHONE # OF

BUSINESS /GOVERNMENT AGENCY

INVOLVED

Awaded acrews / units / # of Months to complete

PERCENT

COMPLETED

PLANNED

Compleate Date

Name of CL associated with this contract and this FIA contract

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. HAVE ANY OF YOUR CONTRACTS BEEN TERMINATED DUE TO PERFORMANCE ? ______YES _____NO

8d. IF “YES” TO 8a. – c. SPECIFY LOCATION(S) AND REASON(S)WHY:

ATTACHMENT C - EXPERIENCE QUESTIONNAIRE

9. ORGANIZATION AND WORKERS THAT WILL BE AVAILABLE FOR THIS PROJECT:

a. MINIMUM # OF CREW LEADERS:___________ AND MAXIMUM # OF CREW LEADERS:__________

b. ARE THESE EMPLOYEES REGULARLY ON YOUR PAYROLL? ______YES _______ NO

c. SPECIFY EQUIPMENT AVAILABLE FOR THIS CONTRACT:______________________________________

d. ESTIMATE RATE OF PROGRESS BELOW (SUCH AS 1.0 PLOTS/ CREW LEADER/DAY):

MINIMUM PROGRESS RATE:_________________ AND MAXIMUM PROGRESS RATE:___________

10a. LIST BELOW THE EXPERIENCE OF THE PRINCIPAL INDIVIDUALS OF YOUR BUSINESS THAT WILL BE ASSIGNED TO COMPLETE THE FIELD

WORK ASSOCIATED WITH THIS CONTRACT

Individual name (s) Designate Crew leader(s) for this contract with an *, the Project Leader with a (PL), and Assistants with **. If the (PL) is also a crew leader = (PL)*.

Position / Title Month’s exp.

with forest inventory, urban inventories, street tree inventories, stand exams, vegetative inventories, canopy and ground cover inventories, & CFI plot work.

Separate out each type of work with its’ own line

Specific description of crew leader’s experience with forest inventory, urban inventories, street tree inventories, stand exams, vegetative inventories, canopy and ground cover inventories, & CFI plot work. Separate out each type of work with its’ own line

% of contract work to be assigned to this crew leader

Education: List the highest level of degree and major held by each crew leader: High School, Associates, Bachelors, or Graduate degree. Include their Major

10b. For each crew leader who is a previous or current NRS conractor, or prevous NRS employee – include scores, dates, and plot identification numbers for all plots checked over the past 24 months. Contractor should provide page 1 of each QA report (include any failed plots):

10c. For each crew leader, list the most recent FIA field guide certification they have achieved, include the number of plots they have completed FIA field plots using that specific field guide.

11a. Remarks: Specify box numbers: (Attach sheets if extra space is needed to fully answer any of the above questions):

11b. Failure to provide complete information will cause affected portions of the bid evaluation to be considerd as unresponsive.

11c. This form is the ONLY format in which this data will be accepted, other formats will be considered as unresponsive

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

12b.

SIGNATURE

13. DATE