ATTACHMENT 5 Relevant Experience Questionaire.doc
DOC document 82 KB Posted
- Attached to
- Drum Chopping National Forests in Florida Federal contract opportunity
- Solicitation number
- 12444121R0063
- Issued by
- Department of Agriculture Forest Service
About this file
This document is a questionnaire for contractors to provide relevant experience for a federal contract opportunity with the US Forest Service. The opportunity involves drum chopping services on approximately 3,000 acres of national forests in Florida. The work includes both single and double drum chopping with a performance period from September 7, 2021 to January 10, 2022. This is a 100% small business set-aside. The questionnaire requests information on the contractor's type of business, years of experience, past projects of similar scope completed within the last three years including contract numbers, award amounts, clients, descriptions of work performed, and references that can be contacted. It also asks about failures to complete work, bonding, experience of principal individuals, credit and banking references, and any additional remarks.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| ATTACHMENT 3C FY21 Chopping Area Comp - 91.pdf | ||
| ATTACHMENT 2B FY21 Wildlife Chopping Area 38 and 42.pdf | ||
| 12444121R0063 SF1449.doc | DOC document | |
| ATTACHMENT 1 Schedule of Items.xlsx | XLSX spreadsheet | |
| ATTACHMENT 4 DOL WAGE RATE.pdf | ||
| ATTACHMENT 2 FY 21 Wildlife Chopping Contract Specs.doc | DOC document | |
| ATTACHMENT 3E FY21 Chopping Area Comp - 41.pdf | ||
| 12444121R0063. Body Solicitation.doc | DOC document | |
| ATTACHMENT 3H FY21 Chopping Area Comp - 83.pdf | ||
| ATTACHMENT 3F FY21 Chopping Area Comp - 46.pdf | ||
| ATTACHMENT 3A FY 21 Chopping General Vicinity Map.pdf | ||
| ATTACHMENT 3 FY21 ChoppingContractSpecs.doc | DOC document | |
| ATTACHMENT 2A FY21 Wildlife Chopping General Vicinity Map.pdf | ||
| ATTACHMENT 3GFY21 Chopping Area Comp - 48 and 49.pdf | ||
| ATTACHMENT 3B FY21 Chopping Area Comp - 228.pdf |
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Text version
AG-4670-S-16-0117
ATTACHMENT 5
RELATIVE EXPERIENCE QUESTIONNAIRE
12444121R0063
ATTACHMENT 5
RELEVANT EXPERIENCE QUESTIONNAIRE
Instructions: See Box 9, remarks, if extra space is needed to answer any item below. Additional sheets may be attached.
1. Contractors Name, Address, Telephone No., & Email
2. Type of Business
__Company __Co-Partner __Non-profit
__Corporation __Individual
3. How many years experience do you have in this line of work____Yrs
4. How many years experience as a prime contractor_____ subcontractor___
5. LIST OF RELEVANT PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST THREE (3) YEARS
NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e., what tasks were performed, (grounds maintenance, erosion control, mulching, forestry work performed, type of equipment used, special safety or requirements) Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________
Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
6a. Have you ever failed to complete any work awarded to you? __yes __ no
6b. Has work ever been completed by performance bond? __yes __ no
6. If "yes" to either item 7a or 7b specify location(s) and reason(s) why
7. List the experience of the principal individuals of your business
| INDIVIDUALS NAME |
| PRESENT POSITION |
| YRS EXP |
| TYPE OF WORK |
8. Information required to complete a responsibility determination of the apparent successful offeror. (Additional information may be requested once a contractor is selected for award.. Moreover, the contractor might need to provide additional authorization from a creditor to grant access.)
a. Credit References
| Company Name/Address |
| Point of Contact |
| Telephone number |
| Materials/Services Provided |
b. Banking Information. (NOTE: Only POC information is required. Please do NOT provide your account information.)
| Company Name/Address |
| Point of Contact |
| Telephone number |
9. REMARKS (Additional sheets may be attached to the experience questionnaire)
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 .