Attach J.5 Experience Questionnaire_3 pages.pdf
PDF 212 KB Posted
- Attached to
- Pipeline Reconstruction - Salmon-Challis NF - ID Federal contract opportunity
- Solicitation number
- 1240LT25Q0009
- Issued by
- Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form from the USDA Forest Service used to evaluate contractor qualifications and capabilities. The three-page form requires contractors to provide detailed information about their business structure, years of experience as prime and sub-contractors, completed projects from the last three years, current contractual commitments, workforce capacity, equipment resources, and key personnel qualifications.
The form includes specific sections for documenting minimum/maximum employee counts, progress rates (such as acres/man/day), and specialized requirements regarding biobased products. For biobased products, contractors must specify manufacturer names, costs, intended uses, biobased content percentages, and demonstrate compliance with USDA-recommended content levels. Contractors must also document their past 3-year experience with biobased products, including specification, purchasing, and installation history. The form requires a certification signature affirming all provided information is complete and correct, and applies these requirements to all proposed subcontractors.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SF30 MOD 0001 1240LT25Q0009.pdf | ||
| RV1 -K-MtnPipelineReconstruct_Attachement 1_Maps.pdf | ||
| RV1 - K-MtnPipelineReconstruct_SOW.pdf | ||
| K-MtnPipeline-PreBid Qs and As.pdf | ||
| Attach J.4 - WD ID20240053 dtd 11-15-24 - 6 Pages.pdf | ||
| SF1442 - 1240LT25Q0009- Final.pdf | ||
| Attach J.1 - SOW - Pipeline Reconstruct - 21 Pages.pdf | ||
| Attach J.2 - SOI - MtnPipelineReconstruct.pdf | ||
| Attach J.3 - Maps - 10 Pages.pdf |
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, 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 and 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 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:
Contract Amount
Type of Project Date Completed
Name, Address, and Telephone No. of Owner/Person to Contact for Project Information
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
Contract Number
Dollar Amt.
of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date Contract Complete
8a. Have you ever failed to complete any work awarded to you? [ ] Yes [ ] No 8b. Has work ever been completed by performance bond? [ ] Yes [ ] No 8c. Did you look at the project site(s) on-the-ground? [ ] Yes [ ] No 8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (2) Maximum number of employees: _____
b. Are employees regularly on your payroll: [ ] Yes [ ] No
c. Specify equipment available for this contract:______________________________________________________
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate:________________ and (2) Maximum progress rate: _________________________
10. List below the experience of the principal individuals of your business: (Who will directly be involved in this contract?)
Individual’s Name Present Position Years of
Experience Magnitude and Type of Work
11. Remarks -- Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question.):
NOTE: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT WILL HELP EVALUATE YOUR ABILITY TO
SUCCESSFULLY COMPLETE THIS PROJECT.
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
b. SIGNATURE (Sign in ink) 13. DATE
Page 3 EXPERIENCE QUESTIONNAIRE CONTINUED
The following is added:
Biobased Products
Offeror shall identify the biobased products to be purchased and used under this contract. For each biobased product, specify the name of the manufacturer, cost of each product, and the intended use of each of the materials that are to be used in carrying out the requirements of the contract. For each biobased product, the Offeror shall specify the percentage of biobased content, and for the USDA-designated biobased content products, the Offeror shall demonstrate that the products to be used under this contract will contain the percentage specified in the USDA recommendations or the highest level of biobased material practicable, consistent with USDA's recommended percentages of biobased content.
The Offeror shall document prior experience in specifying, purchasing, using, and installing biobased products. The Offeror shall provide a list of all relevant contracts over the past 3 years involving the specification, purchase, and/or use of biobased products. The Offeror shall include a list of the biobased products specified, purchased, used, and installed.
The above information shall be provided for all proposed subcontractors in the same format and level of detail as prescribed for the Offeror.
Attach additional sheets, as necessary.
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