Attach 2 Experience Questionnaire.pdf
PDF 294 KB Posted
- Attached to
- Santee Lawn Care and Grounds Maintenance
- Solicitation number
- 12445024Q0012
- Issued by
-
Department of Agriculture Forest Service
About this file
This document includes an Experience Questionnaire and details of a related federal contract opportunity. The Experience Questionnaire is a template for contractors to provide information on their qualifications and past performance for the USDA Forest Service. The related federal contract opportunity is a solicitation from the USDA Forest Service requiring lawn care and grounds maintenance services on approximately eight acres of land. Services will maintain a healthy grass, trees, shrubs, and plants. The NAICS code is 561730 and the period of performance is from April 15, 2024 through April 14, 2025, with four optional years. Offerors must complete the Experience Questionnaire and read the entire synopsis and statement of work. Offers are due by April 7, 2024 at 11:59 PM Eastern Time and must be submitted electronically to the point of contact provided.
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Text version
USDA Forest Service (1/00)
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 10, 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 & 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 in contracting 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 (or currently working) where we can confirm that your company has experience in similar work.
Contract Amount
Type of Project Ongoing or
Date Completed
Name, Address, and Telephone No.
of Owner/Person to Contract for Project Information
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 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
9. List below the experience of the principal individuals of your business:
Individual’s Name
And City of Residence Present Position Years of
Exp.
Magnitude and Type of Work
10. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above questions):
11. 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
12b. Signature (Sign in Ink) 13. Date
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