EXPERIENCE_and_EQUIPMENT_Questionaire.pdf

EXPERIENCE & EQUIPMENT QUESTIONNAIRE

1. Contractor Name, Address, & Telephone Number

EXPERIENCE

3. How many years does your business have in the line of work contemplated by this solicitation?

4. How many years experience in contracting has your business had as a:

(a) Prime Contractor_____ (b) Sub-contractor _____ Is this time concurrent? [ ] YES [ ] NO

5a. List Below all environmental removal/disposal projects your business has completed within the last three (3) years:

Contract Amount Type of Project Date

Completed Name, Address & Telephone Number of

Owner/Person to Contact for Information

5b. List below the Projects that are incomplete:

Contract No. Dollar Amount of Award

Name, Address & Phone No. of Agency Involved

Percent Completed

Dated Completed

6a. Have you ever Failed to Complete any work awarded to you? [ ] YES [ ] NO 6b. Has work ever been completed by performance bond? [ ] YES [ ] NO 6c. If “yes” to either item 6a or 6b specify location(s), reason(s) why and COR: (Attach separate sheet of paper)

EQUIPMENT

7. Number of employees available for this project:

a. Minimum No. of employees ______ & Maximum No. of employees______

b. Are Employees regularly on your payroll? [ ]YES [ ]NO

8. Specify Equipment available for this project:

9. Estimated Rate of Progress (for example in acres/man/day):

Minimum Progress Rate:______________ & Maximum Progress Rate:_________________

10. List Experience of Employees intended to be used on this project:

Individual Name Present Position Years of Exp. Magnitude & Type of Work

11. Did the offeror examine the area(s) for which this quote has been submitted? [ ]YES [ ]NO Certification: I certify that all of the statements made by me are complete and correct to the best of my knowledge. That any persons named as references area authorized to furnish the Forest Service with information needed to verify my capability to perform this project.

Signature Date