Attachment 6 Experience Questionnaire.docx
DOCX document 24 KB Posted
- Attached to
- USDA FS Proper Functioning Condition Survey Federal contract opportunity
- Solicitation number
- 1284LM25Q0069
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire for a USDA Forest Service contract solicitation related to a Proper Functioning Condition (PFC) survey. The questionnaire requires potential contractors to provide detailed information about their business capabilities, including years of experience, past project history, current contractual commitments, employee resources, and key personnel qualifications. Contractors must demonstrate their ability to conduct stream surveys by detailing their professional background, available workforce, and prior relevant work.
The associated federal contract opportunity involves conducting PFC surveys on intermittent and perennial streams within the McKenzie District of Dakota Prairie National Grasslands in McKenzie County, North Dakota. The project is scheduled for summer and autumn 2025, with field work beginning around October 15, 2025, and concluding by January 31, 2026. Contractors are required to submit a final report by the project completion date, with potential flexibility depending on the actual award date. Interested parties can email questions to stevie.fehrs@usda.gov no later than September 24, 2025.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1284LM25Q0069.docx | DOCX document | |
| Attachment 1 Statement of Work.docx | DOCX document | |
| Attachment 3 Lentic and Lotic Forms.pdf | ||
| Attachment 4 Watershed Boundary HUC12.xls | XLS spreadsheet | |
| Attachment 2 Photo Checklist and PFC Additions.pdf | ||
| Attachment 5 Wage Determination.pdf |
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, 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 [ ] Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years experience have you or your business had as a (a) prime contractor ____ and/or (b) sub-contractor ____?
6. List below the projects your business has completed within the last three years:
| Contract Amount |
| Type of Project |
| Date Completed |
| Name, Address, and Telephone No. of Owner/Person to Contact for Project Information |
7. List below all of 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 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:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (2) Maximum number of employees: _____
b. Are employees regularly on your payroll: [ ] Yes [ ] No
c. Specify equipment available for this contract:______________________________________________________
10. 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 |
11. 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.
12a. CERTIFYING OFFICIAL’S NAME AND TITLE
| b. SIGNATURE (Sign in ink) |
| 13. DATE |
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