Attachment 5_PastPerformanceQuestionnaire.pdf
PDF 571 KB Posted
- Solicitation number
- 1240LU26Q0029
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Performance Questionnaire for USDA Forest Service Solicitation #1240LU26Q0029 for West Yellowstone Fire Center Roofing construction work. The document serves as an evaluation tool to assess contractor qualifications and capability rather than a detailed scope of work document.
The questionnaire requires contractors to provide comprehensive information about their business qualifications, including years of experience in the relevant line of work, experience as prime and subcontractors, and detailed descriptions of projects completed within the last three years with contract amounts, completion dates, and owner contact information. Contractors must disclose current contractual commitments running concurrently with the proposed work, including contract numbers, dollar amounts, percent completion status, and expected completion dates. The form specifically asks contractors to confirm whether they have failed to complete awarded work, had work completed by performance bond, and whether they visited the project site on-the-ground. Contractors must provide a narrative of their technical approach to performing the work, estimated progress rates for five specified work items (Mobilization, Demolition, Site Preparation, Repairs & Construction, and Clean Up and Removal), and identification of principal individuals who will directly work on the contract with their positions, experience, and relevant work background. The questionnaire includes a certification section requiring the certifying official's signature, acknowledging that all statements are complete and correct and that named references are authorized to provide verification information to the Forest Service.
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Text version
Solicitation # 1240LU26Q0029 West Yellowstone Fire Center Roofing
Rev. 11/5/25
USDA Forest Service
PERFORMANCE QUESTIONNAIRE
Instructions: See Box 12, 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
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years experience as a (a) prime contractor ______ and/or (b) sub-contractor ______ has your firm performed work similar to this solicitation?
6. List below the projects your business has completed within the last three years:
Contract Amount
Type of Project Date Completed
Name, & Telephone No. of Owner/Person to Contact for Project Information
7. List below 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 your 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:
lrakich Highlight
CONSTRUCTION RFQ Solicitation # 1240LU26Q0029 West Yellowstone Fire Center Roofing
Rev. 11/5/25
PERFORMANCE QUESTIONNAIRE CONTINUED
9. Provide a narrative of your technical approach to performing work for this contract:___________________________________
10. Estimate progress rates for work items:
Item No.
Work Description Estimated No. of Days
Estimated Hours per Day Date of Start End Date
1 Mobilization
11. 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
12. 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.
13a. CERTIFYING OFFICIAL’S NAME AND TITLE
b. SIGNATURE (Sign in ink) 13. DATE
Site Preparation
Demolition
Repairs & Construction
Clean Up and Removal lrakich Highlight lrakich Highlight lrakich Highlight
WilliamGriffith Highlight
WilliamGriffith Highlight
File details come from the government source that posted it. Updated .