ATT 3 Experience Questionairre.pdf
PDF 138 KB Posted
- Attached to
- Farrier Services on the Helena National Forest
- Solicitation number
- 1284LM26Q0024
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a USDA Forest Service Experience Questionnaire form used to evaluate contractor qualifications and capability to perform work on federal forest service contracts.
The questionnaire requires contractors to provide comprehensive information about their business experience, capacity, and key personnel. Contractors must identify their business structure (company, corporation, co-partnership, individual, or non-profit organization) and provide their contact information and the receiving Forest Service office location. The form requests details on years of experience in the relevant line of work and whether the contractor has served as a prime contractor or subcontractor. Contractors must list all projects completed within the past three years, including contract amounts, project types, completion dates, and owner contact information for reference verification. The form also requires disclosure of all concurrent contractual commitments running parallel to the contemplated work, with contract numbers, dollar amounts, awarding entities, units awarded, percent completion, and contract completion dates. Contractors must answer questions regarding past performance failures, performance bond completions, and on-site project inspections. The questionnaire addresses resource availability by requesting minimum and maximum employee counts, confirmation of regular payroll status, specification of available equipment, and estimated minimum and maximum progress rates. Additionally, contractors must provide detailed information on principal individuals who will directly work on the contract, including their names, current positions, years of experience, and the magnitude and type of work they have performed. The form includes space for remarks and additional information to support capability evaluation, and requires certification by an authorized official with signature and date, confirming the accuracy and completeness of all statements provided.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1284LM26Q0024_P0001.pdf | ||
| SF-30.pdf | ||
| ATT 1 Statement of Work.pdf | ||
| 1284LM26Q0024.pdf | ||
| ATT 2 Wage Determinations.pdf |
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, Remarks, if extra space is needed to answer any item below, Mark “X: in appropriate boxes.
1. Contractor Name, Address, and Telephone Number
2. Submitted to (Office Name and Address)
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 have you or your business had as a (a) prime contractor ____ and/or (b) 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, and Telephone No. of Owner/Person to Contact for Project Information
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
Number
Dollar Amt.
of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date
Complete
8a. Have you ever failed to complete any work awarded to you? [ ] Yes [ ] No 8b. Has work ever been completed by performance bond? [ ] Yes [ ] No 8c. Did you look at the project site(s) on-the-ground? [ ] Yes [ ] No 8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (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: _________________________
10. List below the experience of the principal individuals of your business: (Who will directly be involved in this contract?)
Individual’s Name Present Position Years of Experience
Magnitude and Type of Work
11. Remarks -- Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question.):
NOTE: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT WILL HELP EVALUATE YOUR ABILITY TO
SUCCESSFULLY COMPLETE THIS PROJECT.
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
b. SIGNATURE (Sign in ink) 13. DATE
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