Attachment 11 Experience Questionnaire.pdf

EXPERIENCE QUESTIONNAIRE

USDA Forest Service (03/25)

EXPERIENCE QUESTIONNAIRE

Instructions: Mark “x” in appropriate boxes. Attach sheets if extra space is needed to fully answer any questions.

1. Contractor Name, Address, Phone Number, Email Address, & DUNS.

2. Submitted to (Office Name & Address) Northern Region, Regional Office

26 Fort Missoula Rd, Missoula, MT 59801

CO Email: andrea.haines@usda.gov

3. Business ☐ Company ☐ Corporation ☐ Partnership ☐ Individual

4. How many years’ experience does your business have in the line of work contemplated by this solicitation?

5. Years of Experience:

a. How many years’ experience in contracting has your business had as a

(a) Prime Contractor (b) Sub-contractor?

b. Have you ever Failed to Complete any work awarded to you? ☐ YES ☐ NO

c. If “yes” specify location(s), reason(s) why, and CO contact info: (May attach separate sheet of paper)

6. Relevant Experience/Past Performance: List below all Trail Maintenance (or similar) projects your business has completed within the last five years and the complete contact information of individuals who can comment on your performance of the work.

Contract Amount Name of Project and Name of

Business/Government Agency

Date Completed

Name, Phone #, and Email Address of Owner/Person to contact for Performance

Information

7. Concurrent Contractual Commitments: List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation. (Contract Line Items Period of Performance 6/15/2025 – 10/15/2025) Contract Amount Name of Project and Name of

Business/Government Agency Date Awarded Percent

Completed Date Contract

Completed mailto:andrea.haines@usda.gov

EXPERIENCE QUESTIONNAIRE (continued)…

8. Technical and Key Personnel available for this project:

a. (1) Minimum number of employees: (2) Maximum number of employees:

b. Are employees regularly on your payroll? ☐ YES ☐ NO

c. Will you have employees who are capable of performing the work at the start date of the period of performance?

☐ YES ☐ NO

d. Estimated Rate of Progress (e.g., miles averaged per day):

e. Specify equipment available for this contract (if applicable):

9. Employee’s Experience: List below the experience of the principal individuals of your business (supervisor, trail boss, etc.) to perform the work contemplated by this solicitation.

Individual’s Name Present Position Years of Experience Trail Work Experience (Wilderness & Non-

Wilderness)

10. Did the Offeror/Quoter examine the area(s) for which this Quote has been submitted (site visit)?

☐ YES ☐ NO

The offeror may submit their responses on a separate attachment but must answer all questions on the experience questionnaire to be considered for award.

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 Government with any information needed to verify my business and employee’s capability to perform this project.

11a. Certifying Official’s Name and Title (Print):

11b. Contractor Signature: 11c. Date: