FY14NNIS-TES_Survey_Experience_Questionnaire.docx

EXPERIENCE QUESTIONAIRE

Instructions: See Box 13, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.

1. Contractors Name, Address & Telephone No.

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

3.How many years experience do you have surveying plants____Yrs

3a. How many years experience do you have surveying Southeastern flora____Yrs

3b. How many years experience do you have surveying Sandhills flora____Yrs

3c. How many years experience do you have surveying non-native invasive species____Yrs

4. How many years experience as a prime contractor_____ subcontractor___

PAST PERFORMANCE/EXPERIENCE INFORMATION

5. List the projects your business has completed in the last 3 years similar in size and scope.

CONTRACT

NUMBER/

AMOUNT

TYPE OF PROJECT

(NNIS/TES Surveys, acres)

6. List all of your firms current contract commitments

CONTRACT

NUMBER/

AMOUNT

TYPE OF PROJECT

(NNIS/TES Surveys, acres)

7. Have you ever failed to complete any work awarded to you? __yes __ no

8. If "yes" to either item 7specify location(s) and reason(s) why

Work Force:

9. Work force composition that will be used for this project:

a. Minimum No. of employees: and Maximum No. of employees:

b. Are employees regularly on your payroll: __yes __ no

c. Do you have any partime employees? If so how many?

d. Do you have any seasonal employees? If so how many?

e. How will company recruit and train employees who will be working on this contract..

10. EQUIPMENT:

a. Specify equipment to be used on this contract: (GPS,ArcGIS etc.)

b. Indicate condition of equipment to be used on this contract.

c. Standard Operating procedures:

d. Estimate rate of progress (such as 10.0 acres per day):

1. Minimum progress rate: Maximum progress rate

11. KEY PERSONNEL. List the experience of the key personnel (foreman, inspector, operators)performning on this contract and business.

13. REMARKS:

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: