Attachment 6 - Relevant Experience Questionnaire.pdf

12444121R0010

ATTACHMENT 6

RELEVANT EXPERIENCE QUESTIONNAIRE

Instructions: See Box 13, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.

1. Contractors Name, Address & Telephone No.

2. Type of Business __Company __Co-Partner __Corporation __Individual __Non-profit

3. Describe your standard handling procedures in safetguarding seedlings during planting operations.

4. How many years experience do you have in this line of work____Yrs

5. How many years experience as a prime contractor_____ subcontractor___

PAST PERFORMANCE/EXPERIENCE INFORMATION

6. List the projects your business has completed in the last 3 years similar in size and scope.

CONTRACT

NUMBER/

AMOUNT

TYPE OF PROJECT

(Acres planted and type)

PERIOD OF

PERFORMANCE

NAME, ADDRESS & TELEPHONE NO. TO CONTACT FOR

INFORMATION

7. List all of your firms current contract commitments

CONTRACT

NUMBER/

AMOUNT

TYPE OF PROJECT

(Acres treated and type)

PERIOD OF

PERFORMANCE

NAME, ADDRESS & TELEPHONE NO. TO CONTACT FOR

INFORMATION

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

8. If "yes" to either item 7a or 7b specify location(s) and reason(s) why

Work Force:

9. Work force composition (operator, laborer, etc) that will be used for this project:

a. Minimum No. of employees: and Maximum No. of employees:

b. Are employees regularly on your payroll: __yes __ no

Do you have any partime employees? If so how many?

c.. Do you have any seasonal employees? If so how many?

d. How will company recruit and train employees who will be working on this contract:

10. EQUIPMENT:

a. Specify ALL equipment to be used on this contract (Tractor model, Horse power, etc.):

b. Indicate condition of equipment to be used on this contract:

c. Standard Operating procedures:

d. Estimate rate of progress (such as 2.0 acres per day):

1. Minimum progress rate: Maximum progress rate

11. KEY PERSONNEL. List the experience of the key personnel (foreman, inspector, operators)performning on this contract and business.

INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK

12. QUALITY CONTROL PLAN: Provide a draft quality control plan addressing how the Contractor will assure quality meets the contract specifications:

13. REMARKS:

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: