Attachment_5 Experience Questionaire_1244726Q0032.pdf
PDF 171 KB Posted
- Attached to
- Hemlock Woolly Adelgid (HWA) Treatment
- Solicitation number
- 12444726Q0032
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire form used for federal contract solicitations issued by the Forest Service for two separate projects: AGNF Hemlock Woolly Adelgid Treatment (Attachment 05, Contract 12444726Q0032) and AGNF Broadcast Herbicide (Attachment 04, Contract 12444726Q0031).
The questionnaire requires contractors to provide comprehensive information about their qualifications and capacity to perform the work. Contractors must identify their business type (company, corporation, co-partner, non-profit, or individual), years of experience in the line of work, and years of experience as prime contractors or subcontractors. Respondents must list no more than three relevant projects completed within three years of the solicitation issuance date, including contract numbers, award amounts, contact information, completion dates, and work descriptions. Contractors must also disclose all current contract commitments with contract numbers, award amounts, contact information, and the percentage of effort allocated to each. Additional requirements include confirming whether the firm has failed to complete any previously awarded work, specifying minimum and maximum employee counts, confirming whether employees are on regular payroll, listing available equipment, and providing experience information for principal individuals including their names, present positions, years of experience, and type of work. The form concludes with a certification statement that must be signed by an authorized representative with their name, title, and date.
View the file
Other files
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
12444726Q0032Attachment 05 AGNF Hemlock Woolly Adelgid Treatment
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
CONTRACT
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
CONTRACT
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
LanieceNixon Highlight
LanieceNixon Highlight
12444726Q0031Attachment 04 AGNF Broadcast Herbicide
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:
File details come from the government source that posted it. Updated .