Experience_Questionaire.pdf

EXPERIENCE QUESTIONNAIRE

(Attach supplemental pages if more space is needed)

1. Contractor's Name, Address, & Telephone Number:

2. Years of experience in this line of work:

3. Years of experience as a prime contractor: subcontractor:

4. Provide a written summary of experience in similar efforts:

5. List the similar projects your company has completed in the last 3 years:

CONTRACT

AMOUNT

TYPE OF

PROJECT

NAME ADDRESS & PHONE #

TO CONTACT FOR INFORMATION

DATE

COMPLETED

6. List all of your current contract commitments:

CONTRACT

NUMBER

AWARD

AMOUNT

NAME ADDRESS & PHONE #

TO CONTACT FOR INFORMATION

PERCENT

COMPLETED

6a. Have you ever failed to complete any work awarded to you? Yes _ No If yes, explain in 6b.

6b. If "Yes" to 6a specify location(s) and reason(s) why:

7. Organization that will be available for this project:

a. Minimum No. of employees:

b. Maximum No. of employees:

c. Are employees regularly on your payroll: ___ Yes ___ No

8. List the experience of the principal individuals of your business:

INDIVIDUAL'S NAME:

PRESENT POSITION:

YEARS OF EXPERIENCE:

TYPE OF WORK:

9. Explanation of how you will accomplish what you have planned.

All of the statements made by me are complete and correct to the best of my knowledge and 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__________________