Attachment 4 -Past Performance Questionnaire.pdf

This is a USDA Forest Service Past Performance Questionnaire form (References FSH 6309.31 and 41 USC 1) used to evaluate contractor capability and track record prior to contract award.

The form requires contractors to provide their business information including company name, address, and telephone number, along with the receiving Forest Service office details and business type classification (Company, Corporation, Non-profit Organization, Co-partnership, or Individual). Contractors must document years of experience in their line of work and specify years of experience as both prime contractors and subcontractors. The form requires listing all projects completed within the last three years, including contract amount, project type, completion date, and owner/project contact information for reference verification. Additionally, contractors must disclose whether they have ever failed to complete awarded work, with explanation of project type and reasons if applicable. A certification statement requires the contracting official to attest under penalty of perjury that all information provided is complete and correct to the best of their knowledge, and authorizes named references to provide verification information to the Forest Service regarding the contractor's capability to perform the project. The form includes space for the certifying official's name, title, signature in ink, and submission date.