Attachment 5 Experience _Questionaire_25April24.docx

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Attached to
SRS Athens, GA Janitorial Services
Solicitation number
12445024Q0017
Issued by

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This document is an Experience Questionnaire that is part of the solicitation for Janitorial Services at the SRS facilities in Athens, GA (Solicitation No. 12445024Q0017). The questionnaire requests information about the contractor's business type, years of experience, relevant past projects, current contract commitments, equipment and personnel resources, and references to support a responsibility determination.

The related federal contract opportunity is for a one-year base period with four option years to provide janitorial services as defined in the Statement of Work. The services include all personnel, equipment, labor, supervision, transportation, supplies, and materials necessary to perform janitorial and related services. The procurement requires the use of USDA-designated biobased products to the extent they are reasonably available, meet performance standards, and are reasonably priced.

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Other files

File Type Posted
Question and Answers for Athens Janitorial Services.docx DOCX document
Attachment 2 Building Maps Athens-North South Work Units.pdf PDF
Attachment 4 _Schedule of Items_043024.xlsx XLSX spreadsheet
Attachment 1_Statement of Work_30Apr24.docx DOCX document
Combined_Synopsis_Solicittaion_12445024Q0017_Athens_Janitorial_043024.docx DOCX document
Attachment 3 Wage Determination_Clarke_2015-4469_Rev.22, 25April24.pdf PDF

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Solicitation No: 12445024Q0017 Athens Janitorial Services Attachment 5

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
CompanyCo-Partner Non-profit

Corporation Individual

3. How many years of experience do you have in this line of workYrs
4. How many years of experience as a prime contractorsubcontractor

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 CONTRACTNAME, ADDRESS, E-MAIL, & PHONE NO. TO CONTACT FOR INFORMATION.

PERCENT

AWARD AMOUNT

NUMBER

7a. Have you ever failed to complete any work awarded to you?yesno
7b. Has work ever been completed by performance bond?yesno

7c. If "yes" to either item 7a or 7b specify location(s) and reason(s) why

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:

d. Estimate rate of progress (such as 2.0 acres per day):

1. Minimum progress rate: Maximum progress rate

9. List the experience of the principal individuals of your business

INDIVIDUALS NAME
PRESENT POSITION
YRS EXP
TYPE OF WORK

10. Information required to complete a responsibility determination if the apparent successful offeror.

a. Credit References

Company Name/Address
Point of Contact
Telephone number
TYPE OF WORK

b. Banking Information.

Company Name/Address
Point of Contact
Telephone number
TYPE OF WORK

11. 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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