Attachment 4 Experience Questionaire.docx
DOCX document 67 KB Posted
- Attached to
- EL Yunque National Forest - Licensed Water System Operator Services Federal contract opportunity
- Solicitation number
- 12445024Q0011
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire that is part of Solicitation No. 12445024Q0011 for Licensed Water Operator Systems services for the El Yunque National Forest in Puerto Rico. The solicitation requires the contractor to provide all personnel, equipment, labor, supervision, transportation, supplies, and materials necessary to perform water system operator and related services as described in the Statement of Work. The contract will be awarded for one base year with four option years.
The Experience Questionnaire requests information about the contractor's company, including type of business, years of experience, relevant past projects, current contract commitments, and key personnel. The contractor must provide credit references and banking information to facilitate a responsibility determination. Contractors are instructed to include additional remarks if more space is needed to fully answer any of the questionnaire items.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Combined Synopsis Solicitation El Yunque National Forest Licensed Water System Operator Services.docx | DOCX document | |
| Attachment 3 SOW Water Operator.docx | DOCX document | |
| Attachment 2 SCLS Wage Determination.pdf | ||
| Attachment 1 Pricing Abstract.xlsx | XLSX spreadsheet |
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Text version
Solicitation No: 12445024Q0011 Licensed Water Operator Systems Attachment 4
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, 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 | |
| Company | Co-Partner Non-profit |
Corporation Individual
| 3. How many years of experience do you have in this line of work | Yrs |
| 4. How many years of experience as a prime contractor | subcontractor |
5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:
CONTRACT
NUMBER
AWARD
AMOUNT
| NAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION. |
| DATE |
CONTRACT
COMPLETED
DESCRIPTION OF WORK PERFORMED
6. List all of your firms current contract commitments CONTRACTNAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.
PERCENT
AWARD AMOUNT
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" to either item 7a or 7b specify location(s) and reason(s) why
8. Organization information available for this project:
a. Minimum # of employees: and Maximum # of employees:
b. Are employees regularly on your payroll: yes no
c. Specify equipment available for this contract:
d. Estimate rate of progress (such as 2.0 acres per day):
1. Minimum progress rate: Maximum progress rate
9. List the experience of the principal individuals of your business
| INDIVIDUALS NAME |
| PRESENT POSITION |
| YRS EXP |
| TYPE OF WORK |
10. Information required to complete a responsibility determination if the apparent successful offeror.
a. Credit References
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
b. Banking Information.
| Company Name/Address |
| Point of Contact |
| Telephone number |
| TYPE OF WORK |
11. REMARKS
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:
| Name: |
| Title: |
| Date: |
File details come from the government source that posted it. Updated .