Experience_Questionnaire.pdf
PDF 30 KB Posted
- Attached to
- Neb Pine Ridge RD Road Maintenance Federal contract opportunity
- Solicitation number
- AG-82D7-S-17-0011
About this file
Experience Questionnaire
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| AG-82D7-S-17-0011.pdf | ||
| sheet_1_location_map.pdf | ||
| ExhibitB_Specs_modified_level_3_road_maintenance.pdf | ||
| ExhibitC_2017_PRRD_Rdmtc_PRrdmtcMap.pdf | ||
| ExhibitA_2017_PRRD_RdMtc_rdlog.pdf | ||
| sheet_4_rolling_dip.pdf | ||
| sheet_2_vicinity_map.pdf | ||
| AG-82D7-S-17-0011_SOW.pdf | ||
| DOL_Wage_Nebraska.pdf | ||
| sheet_3_ditch_sections.pdf | ||
| ExhibitD_2017_PRRD_Rdmtc_ONGrdmtcMap.pdf |
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Text version
EXPERIENCE
QUESTIONNAIRE
1. CONTRACTOR NAME, ADDRESS AMD PHONE#
2. SUBMITTED TO (Office Name & Address)
USDA Forest Service White River National Forest 900 Grand Ave Glenwood Springs, CO 81601
3. BUSINESS:
__Company _Co-partnership _Corporation
- Individual _Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. HOW MANY YEARS EXPERIENCE IN CONTRACTING HAVE YOU OR YOUR FIRM HAD AS A:
PRIME CONTRACTOR AND/OR SUB-CONTRACTOR____________________
6. LIST BELOW THE PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST THREE YEARS:
CONTRACT
AMOUNT
TYPE OF
PROJECT
DATE
COMPLETED
NAME, ADDRESS, & PHONE OF OWNER PERSONS TO
CONTACT FOR PROJECT INFORMATION
7. LIST BELOW ALL OF YOUR CONTRACTUAL COMMITMENTS RUNNING CONCURRENTLY WITH THE
WORK CONTEMPLATED BY THIS PROJECT:
CONTRACT
NUMBER AMOUNT
OF AWARD
NAME, ADDRESS & PHONE # OF
BUSINESS/GOVERNMENT AGENCY
INVOLVED
AWARDED
(UNITS)
PERCENT
COMPLETED
DATE COMPLETED
Solicitation AG-82D7-S-16-0003 White River National Forest
Snow Removal and Lawn Care Services Aspen and Carbondale Administrative Sites
8a. HAVE YOU EVER FAILED TO COMPLETE ANY WORK AWARDED YOU?
YES NO
8b. HAS WORK EVER BEEN COMPLEED BY PERFORMANCE BOND?
YES NO
8c. IF "YES" TO EITHER ITEMS SPECIFY LOCATION(S) AND REASON(S) WHY:
9. ORGANIZATION AND WORKERS THAT WILL BE AVAILABLE FOR THIS PROJECT:
a. MINIMUM NUMBER OF EMPLOYEES:___ AND MAXIMUM NUMBER OF EMPLOYEES:
b. ARE EMPLOYEES REGULARLY ON YOUR PAYROLL? YES NO____________
c. SPECIFY EQUIPMENT AVAILABLE FOR THIS CONTRCT: __________________________________
d. ESTIMATE RATE OF PROGRESS BELOW (SUCH AS 2.0 ACRES/MAN/DAY):
MINIMUM PROGRESS RATE: AND MAXIMUM PROGRESS RATE: ___________
10. LIST BELOW THE EXPERIENCE OF THE PRINCIPAL INDIVIDUALS OF YOUR BUSINESS:
INDIVIDUAL'S NAME
PRESENT
POSITION
YEARS
OF EXP.
MAGNITUDE AND TYPE OF WORK
Solicitation AG-82D7-S-16-0003 White River National Forest
Snow Removal and Lawn Care Services Aspen and Carbondale Administrative Sites
11. REMARKS: SPECIFY BOX NUMBERS (Attach sheets if extra space is needed to fully answer any of the above questions):
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.
12a. CERTIFING OFFICIAL'S
NAME AND TITLE
l2b. SIGNATURE (Sign in Black Ink)
13. DATE
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