Experience_Questionaire.doc

9. Organization and work that will be available for this project:

a. (1) Minimum number of employees:__________ and a (2) Maximum number of employees:__________

b. Are employees regularly on your payroll? _____ Yes _____ No

c. Specify equipment available for this contract:_______________________________________________

d. Estimate rate of progress below (such as 2.0 acres/man/day):

(1) Minimum progress rate: __________ and (2) Maximum progress rate: __________

e. Describe the safety plan and procedures employed by your firm. Specifically address: 1) how maximum safety is ensured for both employees and the public who may be on the work site during contract performance, 2) First Aid and evacuation plans in the event of an illness or injury.

Use a separate sheet of paper if necessary.

10. List below the experience of the principal individuals of your business:

11. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any 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.Certifying Official’s Name and Title