Attachment 3 - Experience Questionnaire.docx
DOCX document 43 KB Posted
- Attached to
- Pool Creek IRSC Federal contract opportunity
- Solicitation number
- 1282MK20R4001
- Issued by
- Department of Agriculture Forest Service
About this file
This document contains an experience questionnaire and details of a federal contract opportunity for a stewardship integrated resource service contract. The experience questionnaire requests information on the contractor's experience, past performance, available personnel and equipment, experience with biopreferred and sustainable products, and certifications. The federal contract opportunity is for a Pool Creek IRSC covering 1841 acres on national forest lands in Colorado. It is a total small business set-aside requiring use of the System for Award Management to register. The combined synopsis and solicitation does not schedule a site visit and states this announcement is the only one that will be issued for this project.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Appendix A_Work Activity Items.docx | DOCX document | |
| 1282MK20R4001.pdf | ||
| Appendix A1 - Reference - Fuel Loading Models.pdf | ||
| Appendix_C Road Maintenance Specs.docx | DOCX document | |
| Appendix_B_Scaled.doc | DOC document | |
| Attachment 1 - PoolCreek_Map1-2.pdf | ||
| Attachment 2 - Wage Determination.pdf |
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Text version
Experience Questionnaire Instructions: See Box 10, Remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address, & Telephone No.
Email: @ .
2. Type of Business: (Include letter of authorization on who can bind or sign for company) see FAR 4.102
| |_| Sole Proprietor (no letter needed) |
| |_| Partnership (Copy of Agreement w/auth.) |
| |_| Corporation (Agent, authority |
| |_| LLC |
| |_| Non-profit Organization |
| |_| Joint Venture (All Parties sign) |
3. How many years experience do you have in this line of work? Years
4. How many years experience as a prime contractor? As a subcontractor?
5. Relevant Projects: Provide information requested in Factor 2.1 - Experience on relevant projects your business has completed in the last 3 years:
6. List below all of your firm’s contractual commitments running concurrently this solicitation
| Contract Number |
| Award Amount |
| Percent Completion |
| Awarded Units |
| Date Contract Completed |
| Contact Name, Address, & Telephone Number. |
7a. Have you ever failed to complete any work awarded to you? |_| Yes |_| No 7b. Has work ever been completed by performance bond? |_| Yes |_| No 7c. If ‘Yes’ was checked to either item 7a or 7b, specify location(s) and reason(s) why:
7d. Did you look at the project site(s) on-the-ground? |_| Yes |_|No
8. Organization that will be available for this project:
a. |_| All work performed by prime, OR |_| Subcontracting % to be performed by sub. (Include information on Subcontractors)
b. Minimum number of employees: and Maximum number of employees:
c. Are employees regularly on your payroll? |_| Yes |_| No
d. Specify equipment available for this contract:
e. Estimate rate of progress (Such as acres/day, miles/day, or other rate):
Minimum progress rate: Maximum progress rate:
9. List the experience of the principal individuals of your business that will be assigned to this project:
| Individuals Name |
| Present Position |
| Years of Experience |
| Type of Work |
10. Factor 3.1 Biopreferred Product Use:
a. Products to be used on this contract: (Provide justification if using non-designated products.)
a. Provide experience of using sustainable products on past contracts:
b. Cost of Biobased Products to be used on this contract:
11. Remarks:
12. 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 capabilities to perform this project.
| (Printed Name) |
| (Signature) |
| (Title) |
| (Date) |
File details come from the government source that posted it. Updated .