Attachment 4 - Experience Questionnaire.pdf
PDF 310 KB Posted
- Solicitation number
- 12443926Q0054
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form used to evaluate contractor qualifications for a Forest Service project. The form requests comprehensive information about the contractor's background, capacity, and relevant experience to assess suitability for award.
The questionnaire requires contractors to provide basic identifying information including business name, address, telephone number, and business type (company, corporation, co-partner, individual, or non-profit organization). Contractors must document their years of experience in the relevant line of work, experience as prime and subcontractors, and provide detailed information about similar projects completed within the last three years, including contract amounts, work types, completion dates, and client references. Additionally, contractors must list all current contract commitments with award amounts, contact information, percent completion status, and projected completion dates. The form includes yes/no questions regarding failure to complete awarded work and use of performance bonds, with space for explanation if applicable. Section 8 addresses organizational capacity by requesting minimum and maximum employee counts, payroll status, equipment specifications, and estimated progress rates. Section 9 requires listing principal individuals assigned to the project with their positions, years of experience, and work types. The form specifically inquires about Hand Held GPS, Shapefile, and Avenza software experience in Section 10, and requires a work plan description in Section 11. Respondents must provide their SAM UEI number and sign a certification statement affirming the accuracy and completeness of all provided information and authorizing references to cooperate with Forest Service verification efforts.
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Other files
| File | Type | Posted |
|---|---|---|
| Questions.docx | DOCX document | |
| 12443926Q0054 SF1449.pdf | ||
| 12443926Q0054_0001 SF1449.pdf | ||
| RFQ 12443926Q0054_0001.pdf | ||
| Attachment 1 - Statement of Work.pdf | ||
| Attachment 3 - WD 1981-1257 R71.pdf | ||
| RFQ 12443926Q0054.pdf | ||
| Attachment 2 - Maps.pdf |
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Text version
EXPERIENCE QUESTIONNAIRE
1. Contractor’s Name, Address & Telephone
2. Type of Business
___Company ___Co-Partner ___Corporation ___Individual ___Non-profit Organization
3. How many years experience do you have related to this line of work? _______ years
4. How many years experience as a prime contractor? ________years
Subcontractor? _______
5. List all the similar projects your business has completed in the last three (3) years.
CONTRACT
AMOUNT
TYPE OF CONTRACT
WORK
DATE
COMPLETED
Contact Name, Address and Tele. #
6. List all of your firms’ current contract commitments
CONTRACT
NUMBER
AWARD
AMOUNT
Contact Name, Address & Tele. #
Percent Completed
Date Contract Completed
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 above, specify reason(s) and location(s) why.
8. Organization structure that will be available for this project:
a. Minimum No. of employees: _____ and Maximum No. of employees:_____
b. Are employees regularly on your payroll? ___yes ___no
c. Specify equipment to be used for this contract:
d. Estimate rate of progress (exp. 100 feet, 1/8 mile a day, etc…):
Progress Rate of _______________
9. List the experience of the principal individuals of your business tied to this project
NAME PRESENT POSITION YRS
EXP.
TYPE OF WORK
10. Hand Held GPS and Shapefile experience, And/or Avenza Experience:
11. Work plan: Describe plan how to accomplish task.
SAM UEI#_______________
CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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.
Signature Print or Typed Name Title Date
File details come from the government source that posted it. Updated .