EXPERIENCE QUESTIONNAIRE.doc
DOC document 35 KB Posted
- Solicitation number
- AG-5C16-S-09-0005
About this file
Experience Questionnaire
View the file
Other files
| File | Type | Posted |
|---|---|---|
| AG-5C16-S-09-0005[1] Body of Solicitation.rtf | RTF text file | |
| SF33 Solicitation Cover Pages.pdf | ||
| State Map of Areas.JPG | JPG image |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
EXPERIENCE QUESTIONNAIRE
| 1. CONTRACTOR NAME, ADDRESS & PHONE |
| 2. SUBMITTED TO: (Office Name & Address) |
USDA-NRCS
Attn: Bruce Lawrence 771 Corporate Drive, Suite 210
Lexington, KY 40503-5479
| 3. BUSINESS |
| 4. Number of years firm has been in business: |
| 5. Number of years experience in contracting have you or your firm had as a: |
___Company
___ Individual ___Corporation
___Co-partnership
___ Non-profit Organization
| ______ Years |
| _____ Prime Contractor |
_____ Subcontractor
6. LIST BELOW TWO PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN LAST 12 MONTHS.
| CONTRACT AMOUNT |
| TYPE OF PROJECT |
| DATE COMPLETED |
| NAME, ADDRESS & PHONE NO. OF OWNER/PERSON TO CONTACT FOR PROJECT INFORMATION |
Experience Questionnaire
8. A. Have you ever failed to complete any work awarded to you? ___Yes ___No
B. Has work ever been completed by performance bond? ___ Yes ___No
C. If “Yes” to any items, specify locations and reasons why:
9. Workers that will be available for this project:
a. Minimum Number of employees: ____ Maximum number of employees_____
b. Are employees regularly on your payroll? ___Yes ___No
c. Length of time employees have been in your employment: ___ - ___ Years
d. Specify equipment available for this contract: ______________________
10. REMARKS: (If needed)
| CERTIFICATION |
| Certifying Official’s Printed Name and Title |
| 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 NRCS with any information needed to verify my capability to perform this project. |
| Signature (Sign in ink) and Date |
File details come from the government source that posted it. Updated .