Attach 002 - Experience Questionaire.pdf
PDF 215 KB Posted
- Attached to
- GW Jeff National Forest - Mount Rogers Grounds Contract Federal contract opportunity
- Solicitation number
- 12443922Q0003
- Issued by
- Department of Agriculture Forest Service
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attach 003 - Past Performance Questionnaire.pdf | ||
| 12443922Q0003 GW Jeff Mount Rogers Ground Solicitation.pdf | ||
| Attach 001 - Schedule of Items.pdf | ||
| Attach 005 - Wage Determination.pdf | ||
| Attach 004 - Statement of Work.pdf |
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Text version
Solicitation No: 12443922Q0003 GW Jeff National Forest
Mount Rogers Grounds Maintenance
Attachment 002 - Page 1 of 2
NAME, ADDRESS, E-MAIL, & PHONE NO. TO
CONTACT FOR INFORMATION.
AWARD
AMOUNT
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address & Telephone No. Email 2. Type of Business
Company Co-Partner Non-profit Corporation Individual
3. How many years of experience do you have in this line of work Yrs
4. How many years of experience as a prime contractor subcontractor
5. List no more than 5 most relevant projects your business has performed within 3 years of this solicitation issuance date:
CONTRACT
NUMBER
AWARD
AMOUNT
NAME, ADDRESS, E-MAIL, &
PHONE NO. TO CONTACT
FOR INFORMATION.
DATE
CONTRACT
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
CONTRACT
NUMBER
7a. Have you ever failed to complete any work awarded to you? yes no 7b. Has work ever been completed by performance bond? yes no
7c. If "yes" to either item 7a or 7b specify location(s) and reason(s) why
PERCENT
COMPLETED
Solicitation No: 12443922Q0003 GW Jeff National Forest
Mount Rogers Grounds Maintenance
Attachment 002 - Page 2 of 2
8. Organization information available for this project:
a. Minimum # of employees: and Maximum # of employees:
b. Are employees regularly on your payroll: yes no
c. Specify equipment available for this contract:
d. Estimate rate of progress (such as 2.0 acres per day):
1. Minimum progress rate: Maximum progress rate
9. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. Information required to complete a responsibility determination if the apparent successful offeror.
a. Credit References Company Name/Address Point of Contact Telephone number TYPE OF WORK
b. Banking Information.
Company Name/Address Point of Contact Telephone number TYPE OF WORK
11. REMARKS
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:
Name: Title: Date:
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