Attachment 4 Experience Questionaire.pdf
PDF 121 KB Posted
- Solicitation number
- 12444826Q0008
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire for a federal contract opportunity related to Monongahela National Forest Tree Cages (Contract Number 12444826Q0008). The questionnaire is a template designed to evaluate contractor qualifications and capability to perform the project.
The questionnaire requires contractors to provide comprehensive information including: contractor name, address, contact information, and business type (company, corporation, co-partner, non-profit, or individual); years of experience in the line of work and as a prime contractor or subcontractor; up to three most relevant projects completed within three years of solicitation issuance, including contract number, award amount, contact information, completion date, and work description; current contract commitments with contract numbers, award amounts, and contact information; history of work completion; organizational capacity including minimum and maximum employee counts, payroll status, and available equipment; and experience of principal individuals including name, position, years of experience, and type of work performed. The questionnaire also includes a remarks section for additional information and requires certification by the respondent that all statements are complete and correct to the best of their knowledge, with authorization for references to verify capability to perform the project. This template serves as a standard evaluation tool for assessing contractor qualifications for the Monongahela National Forest tree cage project.
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Text version
Attachment #3 - 12444826Q0008 Monongahela N.F. Tree Cages
NAME, ADDRESS, E-MAIL, & PHONE NO. TO
CONTACT FOR INFORMATION.
AWARD
AMOUNT
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
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
NUMBER
7. Have you ever failed to complete any work awarded to you? yes no
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:
PERCENT
Attachment #3 - 12444826Q0008 Monongahela N.F. Tree Cages
9. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. 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:
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