Attachment 1-Experience and Past Performance Questionnaire.pdf

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Attached to
Ammunition-Forest Service, Region 5 Law Enforcement
Solicitation number
127EAT24Q0073
Issued by

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This document is an Experience Questionnaire for a federal contract opportunity. It requests the contractor to provide information on their company, experience, and past performance related to the supply of ammunition to the federal government. The key details include:

The contractor is being asked to submit the questionnaire to the USDA Forest Service Contracting Officer. The questionnaire covers details such as the contractor's business type, years of experience in the required line of work, and a list of previous ammunition supply contracts completed for the federal government in the last 3 years, including contract number, amount, type of ammunition, delivery schedule, and agency contact information. The contractor is also asked to provide information on the place of manufacture of the ammunition and warranty details. The questionnaire includes a certification section for the contractor's authorized official to sign.

This Experience Questionnaire is related to a federal contract opportunity for the supply of ammunition to the USDA Forest Service, Region 5 Law Enforcement, under Solicitation Number 127EAT24Q0073. This is a 100% Small Business set-aside with a NAICS code of 332992 and a size standard of 1,300 employees. Quotes are due by July 24, 2024.

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Previous edition is obsolete FS-6300-27 (3/00)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:
12a CERTIFYING OFFICIALS NAME AND TITLE:
b SIGNATURE Sign in ink:
13 DATE:

File details come from the government source that posted it. Updated .