Attachment 10 - Experience Questionnaire.docx

DOCX document 24 KB Posted

Attached to
USDA Forest Service Dakota Prairie Grasslands Road Maintenance
Solicitation number
1284LM25Q0035
Issued by

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The document is an Experience Questionnaire for a USDA Forest Service contract solicitation for road maintenance in Dakota Prairie Grasslands. The questionnaire requires potential contractors to provide detailed information about their business capabilities, including years of experience, past project history, current contractual commitments, employee resources, and key personnel qualifications. Contractors must disclose their experience as prime or subcontractors, list completed projects from the past three years, specify available employees and equipment, and provide information about principal individuals who will be directly involved in the contract.

The solicitation (Number 1284LM25Q0035) covers three road maintenance projects across Sheyenne, Little Missouri, and Grand River areas, characterized as performance-based service contracts. Contractors can bid on individual or all three projects, and must supply labor, materials, equipment, tools, transportation, and supplies to complete maintenance work. The government will accept questions about the solicitation until Monday, 6/23/2025, and contractors must submit their experience details and qualifications as part of their proposal. The questionnaire includes a certification section where the contractor's official must verify the accuracy of all submitted information.

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Other files

File Type Posted
Attachment 6 - 0002 Wage Determination (Little Missouri).pdf PDF
Attachment 7 - 0003 Statement of Work (Grand River).docx DOCX document
1284LM25Q0035.docx DOCX document
Attachment 9 - 0003 Wage Determination (Grand River).pdf PDF
Attachment 1 - 0001 Statement of Work (Sheyenne).docx DOCX document
Attachment 8 - 0003 Area Maps (Grand River).pdf PDF
Attachment 5 - 0002 Area Maps (Little Missouri).pdf PDF
Attachment 3 - 0001 Wage Determination (Sheyenne).pdf PDF
Attachment 2 - 0001 Area Maps (Sheyenne).pdf PDF
Attachment 4 - 0002 Statement of Work (Little Missouri).docx DOCX document

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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 .