Attach 6_Experience Questionaire.pdf
PDF 122 KB Posted
- Solicitation number
- 12443926Q0178
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form (Attachment #6) for a USDA federal contract opportunity (12443926Q0178). The form is designed to collect detailed information about a contractor's qualifications, experience, and organizational capacity to perform work.
Respondents must provide company information including business type (company, corporation, co-partner, non-profit, or individual), years of experience in the line of work, and years of experience as either a prime contractor or subcontractor. The form requires listing no more than three relevant projects completed within three years of the solicitation issuance date, including contract numbers, award amounts, contact information, completion dates, and work descriptions. Contractors must also disclose all current contract commitments with associated contract numbers, award amounts, contact information, and percentage allocations. Additional organizational details required include minimum and maximum employee counts, confirmation of regular payroll employment, and specification of available equipment. The form includes a section for listing principal individuals with their present positions, years of experience, and type of work performed. A remarks section is available for additional information, and the form concludes with a certification statement attesting to the accuracy and completeness of all submitted information. Completed questionnaires must be returned no later than August 1, 2026 at 5:00 PM ET via email to Christopher Hamilton at christopher.j.hamilton@usda.gov.
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Text version
12443926Q0178 Attachment #6
NOTE: Please return no later than COB August 01, 2026 @ 1700 ET via email to Christopher Hamilton @ christopher.j.hamilton@usda.gov
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 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
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
NUMBER
7. Have you ever failed to complete any work awarded to you? yes no
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:
PERCENT
12443926Q0178 Attachment #6
NOTE: Please return no later than COB August 01, 2026 @ 1700 ET via email to Christopher Hamilton @ christopher.j.hamilton@usda.gov
9. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. 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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