Attachment 1 EXPERIENCE QUESTIONNAIRE.docx
DOCX document 19 KB Posted
- Attached to
- Woods Creek Range Fence Removal Federal contract opportunity
- Solicitation number
- 1240LN23Q0033
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire for contractors interested in the Woods Creek Range Fence Removal solicitation issued by the Department of Agriculture Forest Service. The questionnaire collects information on the contractor's experience, past performance, equipment, personnel, and qualifications relevant to the project. It requests details on the contractor's years of experience in the relevant line of work, as a prime contractor and subcontractor, as well as a list of recently completed similar projects with owner references. The contractor must also disclose any past failures to complete work or projects completed by bond, look at the project site, available employees and equipment, estimated rates of progress, and experience of principal individuals involved. The completed questionnaire requires certification and signature by an authorized official for consideration in awarding the fence removal solicitation.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| RFQ 1240LN23Q0033 0002 Amendment.pdf | ||
| Addenda 1 DDR Clauses.pdf | ||
| RFQ 1240LN23Q0033 0001 Amendment.pdf | ||
| Attachment 3 Maps West.pdf | ||
| Attachment 2 Maps East.pdf | ||
| RFQ 1240LN23Q0033 Woods Creek Fence Removal.pdf | ||
| Attachment 4 Wage Determination.pdf |
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Text version
EXPERIENCE QUESTIONNAIRE
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, Telephone Number & Email
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 |
File details come from the government source that posted it. Updated .