Attachment 4 Experience Questionnaire.docx
DOCX document 24 KB Posted
- Solicitation number
- 1284LM25Q0011
- Issued by
-
Department of Agriculture Forest Service
About this file
The document is an Experience Questionnaire for a USDA Forest Service contract solicitation, designed to gather detailed information about a potential contractor's qualifications and capabilities. The questionnaire requires contractors to provide comprehensive details including years of experience, past project history, current contractual commitments, employee and equipment resources, and key personnel backgrounds. Specific sections require contractors to list completed projects from the last three years, disclose any failed contract completions, specify available employees and equipment, and certify the accuracy of provided information.
The questionnaire is specifically related to a dust abatement project at the West Glacier River access site in Montana, where the contractor will be responsible for blading and applying dust palliative to approximately 0.2 miles of road between June 1 and July 15. The project aims to reduce dust at a heavily used river access site adjacent to a residential community, with an estimated requirement of 7 tons of dust palliative. Contractors must demonstrate relevant experience and capability to successfully execute the project, with questions designed to evaluate their technical competence, resources, and past performance in similar work.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1284LM25Q0011 AMD 0001.docx | DOCX document | |
| SF-30 AMD 0001.pdf | ||
| Attachment 3 FP-14 Dust Palliative Spec.pdf | ||
| Attachment 2 FP-14 Dust Palliative Mixtures.pdf | ||
| Attachment 1 West Glacier River Access Site Map and Site Plan.pdf | ||
| 1284LM25Q0011.docx | DOCX document | |
| Attachment 5 SCA Wage Determination.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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 .