Attachment 1 Experience Questionnaire.docx
DOCX document 24 KB Posted
- Attached to
- Emergency Back Up Generators Redmond Air Center
- Solicitation number
- 1202RZ25Q0004
- Issued by
-
Department of Agriculture Forest Service
About this file
The document is an Experience Questionnaire for a USDA Forest Service contract opportunity involving emergency backup generators. The questionnaire requires potential contractors to provide detailed information about their business, including years of experience, past project history, current contractual commitments, employee and equipment availability, and key personnel qualifications. Contractors must disclose their ability to complete previous projects, list completed contracts within the last three years, and certify the accuracy of their submitted information.
The accompanying federal contract opportunity seeks a 350 KW 480v 3-phase portable diesel generator for temporary emergency backup power at the Redmond Air Center Air Tanker Base in Redmond, Oregon, for the 2025 fire season. Offerors are required to be registered in the System for Award Management (SAM) and complete electronic representations and certifications. The solicitation (Number 1202RZ25Q0004) is issued by the Department of Agriculture, US Forest Service, and aims to ensure backup power capabilities for the air tanker base during the upcoming fire season.
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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:______________________________________________________
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 .