Atch 2 3 in MS WOrd ag4146s120039.rtf

Uchee Range Road Improvements-Tuskegee a RD AG-4146-S-12-0039

ATTACHMENT 2 –Experience Questionnaire Instructions: See Box 7, remarks, if extra space is needed to answer any item below. Additional sheets may be attached.

1. Contractors Name, Address & Telephone No.

2. Type of Business __Company __Co-Partner __Non-profit __Corporation __Individual

3. Howmany years experience do you have in this line of work____Yrs

4. How many years experience as a prime contractor_____ subcontractor___

LIST OF PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST 3 YEARS

NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included. ((i.e. Type of road work completed, quantities involved, other type of similar work accomplished, type of equipment used, special safety requirements)Use of only a project title does not usually provide enough detail for the Government to make an evaluation.

Project & Location ______________________________________________________________________________________________ Contract Number:_______________________________ Award Amount: ________________________________________________ Period of Performance and/or completion date: ________________________________________________________________________ Client/Company’s Name/Address: __________________________________________________________________________________ Contact Name, email and Telephone number: ________________________________________________________________________ Description of Services (refer to note in No. 5 Type of roadwork performed, quantities involved, etc.) ______________________________________________________________________________________________________________ P Project & Location ______________________________________________________________________________________________ Contract Number:_______________________________ Award Amount: ________________________________________________ Period of Performance and/or completion date: ________________________________________________________________________ Client/Company’s Name/Address: __________________________________________________________________________________ Contact Name, email and Telephone number: ________________________________________________________________________ Description of Services (refer to note in No. 5 Type of roadwork performed, quantities involved, etc.) ______________________________________________________________________________________________________________ Project & Location ______________________________________________________________________________________________ Contract Number:_______________________________ Award Amount: ________________________________________________ Period of Performance and/or completion date: ________________________________________________________________________ Client/Company’s Name/Address: __________________________________________________________________________________ Contact Name, email and Telephone number: ________________________________________________________________________ Description of Services (refer to note in No. 5 Type of roadwork performed, quantities involved, etc.) ______________________________________________________________________________________________________________ Project & Location ______________________________________________________________________________________________ Contract Number:_______________________________ Award Amount: ________________________________________________ Period of Performance and/or completion date: ________________________________________________________________________ Client/Company’s Name/Address: __________________________________________________________________________________ Contact Name, email and Telephone number: ________________________________________________________________________ Description of Services (refer to note in No. 5 Type of roadwork performed, quantities involved, etc.) ______________________________________________________________________________________________________________ 6a. Have you ever failed to complete any work awarded to you? __yes __ no 6b. Has work ever been completed by performance bond? __yes __ no

6. If "yes" to either item 7a or 7b specify location(s) and reason(s) why

7. REMARKS (Additional sheets may be attached to the experience questionnaire)

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:

Name:

Title:

Date:

ATTACHMENT 3 – Past Performance Questionnaire

SECTION I: CONTRACTOR INFORMATION

A. Your Company Name and Address:_____________________________________________________

B. Phone /Fax #: _____________________________________________________________________

C. Point of Contact/email address: ________________________________________________________

D Authorization is hereby granted to provide the information requested in SECTION II and III of this questionnaire.

Signature of Authorized Contractor Representative Date

Printed Name and Title of Authorized Contractor Representative

SECTION II: RESPONDENT INFORMATION: Request a reference from respondent by completing by completing Section II and III and return as directed by contractor requesting the reference.

A. Client/Reference Name and Address: ___________________________________________________

B. Phone/Fax #: ______________________________________________________________________

C. Point of Contact/email address: ________________________________________________________

D. Reference Contract Number: __________________________________________________________ Project Title _______________________________________________________________________ Contract Value/Type: ________________________________________________________________ Period of Performance: _______________________________________________________________ How long have you worked with the contractor: ___________________________________________ More detailed description of the work performed____________________________________________

E. Date completed: ___________________________________________________________________

RATING

DEFINITION

E= Exceptional/High Confidence Based on the contractor’s performance record, essentially no doubt exists that the contractor will successfully perform the required effort.

VG=Very Good/Significant Confidence Based on the contractor’s performance record, little doubt exists that the contract will successfully perform the required effort.

S=Satisfactory/Confidence Based on the contractor’s performance record, some doubt exists that the contractor will successfully perform the required effort.

N=Neutral/Unknown Confidence No performance record identifiable (see FAR 15.305(a)(2) (iii) and (iv)).

M=Marginal/Little Confidence Based on the contractor’s performance record, substantial doubt exists that the contractor will successfully perform the required effort. Changes to the contractor’s existing processes may be necessary in order to achieve contract requirements.

U=Unsatisfactory/No Confidence Based on the contractor’s performance record, extreme doubt exists that the contractor will successfully perform the required effort.

SECTION III: PERFORMANCE EVALUATION

A. CONTRACT PERFORMANCE

1.

Working relationship with your Company?

E

VG

S N M U N/A

2.

How well did the contractor provide experienced workers, managers and supervisors with the technical and administrative abilities needed?

E

VG

S N M

3.

Did the contractor exhibit knowledge of and compliance with government (or other) regulations and industry standards?

E

VG

S N M

4.

How well did the contractor provide and properly maintain operational equipment throughout the term of the contract?

E

VG

S N M

5.

Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract?

E

VG

S N M

6.

How well did the contractor comply with Environmental, health, labor laws, safety and security requirements?

E

VG

S N M

7.

How well did the contractor coordinate and control subcontractors, if any?

8.

Contractor’s Overall Performance E

VG

S N M

B. QUALITY OF SERVICE/CONTROL

Contractor’s accomplishment in meeting the quality standards E

VG

S N M

The contractor provided an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain.

E

VG

S N M

Contractor identified and corrected deficient Work E

VG

S N M

4.

Contractor’s Overall Quality of Workmanship E

VG

S N M

TIMELINESS OF PERFORMANCE

How well did the contractor comply with the contract schedule?

E

VG

S N M

Did the contractor provide timely and accurate records, submittals, and/or reports?

E

VG

S N M

How well did the contractor resolve any delays?

E

VG

S N M U N/A REMARKS: For ratings above or below satisfactory, please provide remarks to describe the reasons for the rating. If additional remarks are necessary, please attach an additional sheet. ___________________________________________________