Attachment 6_PastPerformanceQuestionnaire.pdf
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- Solicitation number
- 1240LU26Q0027
- Issued by
-
Department of Agriculture Forest Service
About this file
Summary
This is a Performance Questionnaire form used by the USDA Forest Service for solicitation #1240LU26Q0027 regarding GAC Site Preparation Construction. The form functions as an evaluation tool to assess contractor capability and experience prior to contract award. Contractors must provide their business information, years of experience in the line of work, prime and sub-contractor experience on similar projects, and a detailed list of projects completed within the last three years including contract amounts, project types, completion dates, and owner contact information for reference verification.
The questionnaire requires contractors to disclose concurrent contractual commitments, document any history of incomplete work or performance bond completions, and confirm on-the-ground site inspection. Additionally, contractors must submit a narrative describing their technical approach, provide estimated progress rates for six work items (mobilization, coordination with local groups, site preparation, electrical work, water and wastewater, and trailer pad installation), and list principal individuals directly involved in contract performance with their experience and work magnitude. The form requires certification by a company official that all statements are complete and correct, and authorizes the Forest Service to verify capability through named references.
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Text version
Solicitation # 1240LU26Q0027
GAC Site Preparation Const.
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 # 1240LU26Q0027
GAC Site Preparation Construction
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
Trailer Pad Installation
Site Preparation
Electrical Work
Water & Wastewater
Coordination w/ local groups lrakich Highlight lrakich Highlight lrakich Highlight
WilliamGriffith Highlight
WilliamGriffith Highlight
WilliamGriffith Highlight
WilliamGriffith Highlight
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