Attachment 1-Experience and Past Performance Questionnaire.pdf

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Attached to
Ammunition - Law Enforcement, USDA Forest Service R5
Solicitation number
127EAT24Q0058
Issued by

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This document is an Experience Questionnaire related to a federal contract opportunity for Ammunition - Law Enforcement, USDA Forest Service R5. The questionnaire asks the contractor to provide information on their business structure, years of relevant experience, previous federal government contracts for ammunition supply, manufacturing locations, and warranty information. The related federal contract opportunity is a Request for Quotation (RFQ) for commercial ammunition products, with a 100% small business set-aside under NAICS code 332992. The solicitation number is 127EAT24Q0058, and quotes are due on Monday, June 24 at 5:00 p.m. Pacific Time. The contracting officer is Catherine A. Sullivan of the USDA Forest Service.

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Schedule of Items REV 6142024.xlsx XLSX spreadsheet
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Previous edition is obsolete FS-6300-27 (3/00)

USDA – Forest Service

EXPERIENCE QUESTIONNAIRE

(Ref. FSH 6309.31 and 41 USC 1)

INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.

1. CONTRACTOR NAME, ADDRESS, TELEPHONE NO, EMAIL

2. SUBMITTED TO (office Name and Address)

Catherine A Sullivan, Contracting Officer 1323 Club Drive Vallejo, CA 94592 Email: catherine.sullivan@usda.gov

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?

3. Proposed Delivery Date/Schedule:

5. List below the Ammunition Supply Orders your business has completed for the Federal Government within the last three (3) years:

CONTRACT

NUMBER

CONTRACT

AMOUNT

TYPE OF

AMMUNITION

DELIVERY

SCHEDULE MET?

AGENCY, NAME, ADDRESS, AND TELEPHONE NO.

OF OWNER/PERSON TO CONTACT FOR PROJECT

INFORMATION

6. Place of Manufacture of ammunition:

7. Please describe your Warranty Information.

CERTIFICATION

I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any person’s name 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

mailto:catherine.sullivan@usda.gov

1 CONTRACTOR NAME ADDRESS TELEPHONE NO EMAIL:
Company: Off
Corporation: Off
Nonprofit Organization: Off
Copartnership: Off
Individual: Off
4 How many years do you or your firm have in the line of work contemplated by this solicitation:
3 Proposed Delivery DateSchedule:
CONTRACT NUMBERRow1:
CONTRACT AMOUNTRow1:
TYPE OF AMMUNITIONRow1:
DELIVERY SCHEDULE METRow1:
AGENCY NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow1:
CONTRACT NUMBERRow2:
CONTRACT AMOUNTRow2:
TYPE OF AMMUNITIONRow2:
DELIVERY SCHEDULE METRow2:
AGENCY NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow2:
CONTRACT NUMBERRow3:
CONTRACT AMOUNTRow3:
TYPE OF AMMUNITIONRow3:
DELIVERY SCHEDULE METRow3:
AGENCY NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow3:
CONTRACT NUMBERRow4:
CONTRACT AMOUNTRow4:
TYPE OF AMMUNITIONRow4:
DELIVERY SCHEDULE METRow4:
AGENCY NAME ADDRESS AND TELEPHONE NO OF OWNERPERSON TO CONTACT FOR PROJECT INFORMATIONRow4:
6 Place of Manufacture of ammunition:
7 Please describe your Warranty Information:
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 name as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project:
12a CERTIFYING OFFICIALS NAME AND TITLE:
b SIGNATURE Sign in ink:
13 DATE:

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