EXHIBIT_1_Experience_Capability_Question.doc

DOC document 67 KB Posted

Attached to
Short Term Lease Federal contract opportunity
Solicitation number
AG-82AT-S-08-0009
Issued by
Department of Agriculture Forest Service

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EXHIBIT_1_Experience_Capability_Question

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EXHIBIT_3_Vehicle_Inspection_Report.rtf RTF text file
EXHIBIT_2_SAMPLEPROPERINVOICE.doc DOC document
SCHEDULE_OF_ITEMS.xls XLS spreadsheet
RFQ_Commercial_Items.doc DOC document

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Text version

Exhibit 1

EXPERIENCE AND CAPABILITY QUESTIONNAIRE -- OMB Clearance Number 9000-0142 Instructions: See Box 10, REMARKS, if extra space is needed to answer any items below. Mark "X" in the appropriate boxes. Please list NA for inapplicable items.

1. Contractor's Name, Address & Telephone Number
2. Type of Business

FORMCHECKBOX

Company

FORMCHECKBOX

Corporation

FORMCHECKBOX

Non-profit Organization

FORMCHECKBOX

Co-partner

FORMCHECKBOX

Individual

3. How many years of experience do you have in this line of work?

4. How many years of experience as a prime contractor?

5. List the projects your business has completed in the last 3 years.

Contract Amount

Type of Project
Date

Completed Name and Telephone Number to Contact For Information

6. List all of your firm's current contract commitments.

Contract Number Contract Amount

Type of Project
Est. Date of

Completion Name and Telephone Number to Contact For Information

7a. Have you ever failed to complete any work awarded to you? FORMCHECKBOX yes FORMCHECKBOX no 7b. Has work ever been completed by performance bond? FORMCHECKBOX yes FORMCHECKBOX no 7c. If "yes" to either Question 7a. or 7b., please specify location(s) and reason(s):

EXPERIENCE AND CAPABILITY QUESTIONNAIRE -- OMB Clearance Number 9000-0142

8. Organization that will be available for this project:

a.

Minimum No. of employees:

b.

Are employees regularly on your payroll? FORMCHECKBOX yes FORMCHECKBOX no c.

If applicable, specify equipment available for this contract:

d.

If applicable, estimate rate of progress (such as 2.0 acres per day):

Minimum progress rate:

9. List the experience of the principal individuals of your business.

Individual's Name
Present Position
Years Experience
Type of Work

10. Remarks:

CERTIFICATION: I certify that all of the statements made above are complete and correct to the best of my knowledge and that ny persons named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.

Signature Title Date

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