Attachment 5 Relevant Experience Questionnaire.pdf

PDF 176 KB Posted

Attached to
Timber Support for Florida National Forests Federal contract opportunity
Solicitation number
12444123R0010
Issued by
Department of Agriculture Forest Service

View the file

Other files for this federal contract opportunity

Show all 14

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

12444123R0010

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 6a or 6b 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 .