Attachment 6 -Experience Questionnaire.pdf
PDF 490 KB Posted
- Solicitation number
- 1240LU26Q0117
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a USDA Forest Service Experience Questionnaire form designed to collect information from contractors seeking to bid on Forest Service contract opportunities. The form must be submitted to the Forest Service PPS office located at 1019 N 5th Street, Custer, SD 57730.
The questionnaire requires contractors to provide their business information, including contractor name, contact details, business type (company, corporation, co-partnership, individual, or non-profit organization), and years of experience in the relevant line of work. Contractors must document their contracting experience as both prime contractors and subcontractors, and provide detailed information about similar projects completed within the last three years, including contract amounts, federal contract numbers if applicable, project types, completion dates, and contact references for verification. The form also requires disclosure of any failed projects or work completed under performance bond, with specific locations and reasons if applicable.
Additionally, contractors must detail their organizational capacity for the project, including minimum and maximum employee availability, whether employees are regularly on payroll, and equipment available for the contract. The form requires a listing of principal individuals within the business, including their names, cities of residence, present positions, years of experience, and the magnitude and type of work they have performed. A certification statement signed in ink by an authorized official attests to the accuracy and completeness of all submitted information and authorizes the Forest Service to verify the contractor's capability to perform the project through named references.
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Other files
| File | Type | Posted |
|---|---|---|
| 1240LU26Q0117 amendment 1.pdf | ||
| QandAs MTDC HVAC conversion.docx | DOCX document | |
| Attachment 2 -Schedule of Items Env Chamber.docx | DOCX document | |
| Attachment 4 -USFS Conditioning Chamber Narrative.docx | DOCX document | |
| 1240LU26Q0117 MTDC HVAC conversion.pdf | ||
| Attachment 3 - Statement of Objectives_EnvChamber_rp.docx | DOCX document | |
| Attachment 5 -Wage Determinations mt63.pdf |
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Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 10, Remarks, if extra space is needed to answer any item below. Mark “x” in appropriate boxes.
1. Contractor Name, email Address, and phone number
2. Submitted to (Office Name & Address) 3. Business type 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 in contracting 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 (or currently working) where we can confirm that your company has experience in similar work.
Contract Amount & Federal Contract # if applicable
Type of Project Ongoing or
Date Completed
Person to Contact for Project Information include email or phone #
7a. Have you ever failed to complete any work awarded to you? _____ Yes _____ No 7b. Has work ever been completed by performance bond? _____ Yes _____ No 7c. If “Yes” to either item 7a or 7b specify location(s) and reason(s) why:
Forest Service PPS 1019 N 5th St Custer, SD 57730
8. Organization and work that will be available for this project:
a. (1) Minimum number of employees:__________ and a (2) Maximum number of employees:__________
b. Are employees regularly on your payroll? _____ Yes _____ No
c. Specify equipment available for this contract
9. List below the experience of the principal individuals of your business:
Individual’s Name
And City of Residence Present Position Years of
Exp.
Magnitude and Type of Work
10. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above questions):
11. 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
12b. Signature (Sign in Ink) 13. Date
File details come from the government source that posted it. Updated .