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- Janitorial Service Bankhead Ranger Distirct
- Solicitation number
- AG-4146-S-16-0023
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Janitorial Services Bankhead RD
AG-4146-S-16-0023.
Janitorial Services Bankhead RD
AG-4146-S-16-0023.
TTACHMENT 3
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 8, 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. How many years of experience do you have in this line of work____ Years
4. How many years of experience as a prime contractor_____ subcontractor___
5. LIST OF PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST 5 YEARS
NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e. size (SF) of building cleaned, type of facility, type of cleaning performed, how often service performed) 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 and Telephone number: ___________________________________________________________________
Description of Services (refer to note in No. 5 above) Detailed description of janitorial services completed.
Project & Location ___________________________________________________________________________________
Contract Number:_______________________________ Award Amount: _____________________________________
Period of Performance and/or completion date: _____________________________________________________________
Client/Company’s Name/Address: _______________________________________________________________________
Contact Name and Telephone number: ___________________________________________________________________
Description of Services (refer to note in No. 5 above Detailed description of janitorial services completed.
Project & Location ___________________________________________________________________________________
Contract Number:_______________________________ Award Amount: _____________________________________
Period of Performance and/or completion date: _____________________________________________________________
Client/Company’s Name/Address: _______________________________________________________________________
Contact Name and Telephone number: ___________________________________________________________________
Description of Services (refer to note in No. 5 above) Detailed description of janitorial services completed.
Project & Location ___________________________________________________________________________________
Contract Number:_______________________________ Award Amount: _____________________________________
Period of Performance and/or completion date: _____________________________________________________________
Client/Company’s Name/Address: _______________________________________________________________________
Contact Name and Telephone number: ___________________________________________________________________
Description of Services (refer to note in No. 5 above) Detailed description of janitorial services completed.
Project & Location ___________________________________________________________________________________
Contract Number:_______________________________ Award Amount: _____________________________________
Period of Performance and/or completion date: _____________________________________________________________
Client/Company’s Name/Address: _______________________________________________________________________
Contact Name and Telephone number: ___________________________________________________________________
Description of Services (refer to note in No. 5 above) Detailed description of janitorial services ompleted.
6a. Have you ever failed to complete any work awarded to you? __yes __ no
6b. Have you defaulted on any work? __yes __ no
6c. If "yes" to either item 6a or 6b specify location(s) and reason(s) why
7. List the experience of the primary individuals to perform on proposed project
| INDIVIDUALS NAME |
| PRESENT POSITION |
| DEGREE/YRS EXP |
| TYPE OF WORK |
8. 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 4* – Past Performance Questionnaire (PPQ)
· 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
Section II and III and return to myeaton@fs.fed.us or Fax – 334-241-8177
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 |
| 2. |
| How well did the contractor provide experienced workers, managers and supervisors with the technical and administrative abilities needed? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| How did the contractor meet contract cleaning standards? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 4. |
| How well did the contractor provide and properly maintain equipment and supplies throughout the term of the contract? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 5. |
| Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 6. |
| Contractor’s Overall Performance |
| E |
| VG |
| S |
| N |
| M |
| U |
B. QUALITY OF SERVICE/CONTROL
| 1. |
| Contractor’s accomplishment in meeting the quality standards |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| The contractor provided an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| Contractor identified and corrected deficient Work |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 4. |
| Contractor’s Overall Quality of Workmanship |
| E |
| VG |
| S |
| N |
| M |
| U |
TIMELINESS OF PERFORMANCE
| 1. |
| How well did the contractor comply with the contract cleaning schedule ? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| How well did the contractor notify you of any schedule changes? |
| 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. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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