Attach 08_Experience Questionaire.docx
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- Solicitation number
- 12443926Q0161
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for Solicitation No. 12443926Q0161, a Request for Quotation (RFQ) issued by the Department of Agriculture Forest Service for mastication of herbicide-treated openings on the George Washington & Jefferson National Forests in Virginia and West Virginia. The questionnaire is a template designed to collect detailed information from prospective contractors regarding their qualifications, experience, and capacity to perform this work.
The form requires contractors to provide company information, years of experience in forestry-related work, relevant project history from the past three years, current contract commitments, and details about organizational capacity including minimum and maximum employee counts, equipment availability, and estimated progress rates. Contractors must also list principal individuals with relevant experience, provide credit and banking references for responsibility determination, and certify the accuracy of their responses. The questionnaire specifically addresses contractor history, including whether work has previously failed to be completed or required performance bonds. This Small Business Set-Aside acquisition falls under NAICS code 115310 (Support Activities for Forestry) with a small business size standard of $11.5 million, and all responsible sources may submit offers for consideration.
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Text version
Solicitation No: 12443926Q0161 GW&J NF NNIS Mastication of Herbicide Treated Openings Attachment 08
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 3 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 CONTRACTNAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.
PERCENT
AWARD AMOUNT
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
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 |
| N/A |
| N/A |
| N/A |
b. Banking Information.
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
| N/A |
| N/A |
| N/A |
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: |
File details come from the government source that posted it. Updated .