Exp. Qstnr.doc

EXPERIENCE QUESTIONNAIRE

Name of Contractor: __________________________

Please provide information that is relevant to this project.

Please list in the table below your work experience over the last three years.

Type of

Project

Dollar

Amount

Date

Completed

Customer/Reference Information

Name Address

Phone

Please list in the table below the equipment that will be utilized on this project.

Type of

Equipment

Model Number/Size

Overall

Condition

Owned or Rented

Please answer the following questions.

• How many years experience do you have with this type of work?

• Do you have any other contractual commitments that may run concurrently (if awarded a contract) under this solicitation? _________________

• If the answer to the above is yes, please list these projects here.______________________________________________________________

Please complete the following table for the employees that will be working on this project.

Employee

Name

Employee

Classification

Employment

Status

Permanent

OR Seasonal

Years

Experience

Is

Employee

Qualified?

• Have you ever been defaulted on any Federal Government contract?

• If the answer to the above is yes, explain the circumstances and list the name of the Contracting Officer.