Attach 3 - Experience_Questionnaire.docx
DOCX document 23 KB Posted
- Solicitation number
- 12444024Q0007
- Issued by
-
Department of Agriculture Forest Service
About this file
This document contains an experience questionnaire and details of a solicitation for recreational site operational grounds services. The contractor shall provide all supervision, personnel, transportation, equipment, supplies, services, permits, and licenses necessary to provide recreation site grounds operational services, which include grass cutting, trimming and edging, recreation area cleaning, toilet and shower building cleaning, and recreation area litter pickup. The work will be covered by a firm fixed price IDIQ service contract and performed at recreation areas on the Bankhead Ranger District. Quotes must be sent to kristina.m.taylor-thomas@usda.gov no later than March 29, 2024 at 5:00 PM Eastern Time. The solicitation was issued by the United States Department of Agriculture Forest Service.
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Text version
EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE
Instructions: Use Item No. 10 Remarks if extra space is needed to answer any item below. Answer all items.
1. Contractor’s Name, Address & Telephone Number.
2. Type of Business
| Company | Co-Partner |
| Corporation | Individual |
| Non-profit Organization |
| 3. How many years’ experience do you have in this Line of work? | Years | |
| 4. How many years’ experience as a Prime Contractor? | ||
| Years | ||
| Subcontractor? | Years |
5. List the projects your business has completed in the last three (3) years.
COMPANY NAME, ADDRESS , TELEPHONE NUMBER AND CONTACT
PERSON
| CONTRACT TYPE/PROJECT DESCRIPTION |
| CONTRACT AMOUNT |
| PERIOD OF PERFORMANCE/DATE COMPLETED |
| 1. | List all of your firms’ current contract commitments. |
| CONTRACT |
NUMBER
AWARD
AMOUNT
Contact Name, Address & Telephone Number Percent Completed Date Contract Completed
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 above, specify reason(s) and location(s) why.
Solicitation
No.
1244402 Q
XXXX
Attachment
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: | and Maximum No. of employees: | |
| b. Are employees regularly on your payroll? | Yes | No |
c. Specify equipment available for this contract:
9. List the experience of the principal individuals of your business
| NAME |
| PRESENT POSITION |
| YEARS |
EXPERIENCE
TYPE OF WORK
10. REMARKS
CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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.
Signature Print or Typed Name Title Date Duns # Tax ID#
File details come from the government source that posted it. Updated .