Attachment 7 - Experience Questionnaire_3 pages.pdf
PDF 255 KB Posted
- Attached to
- Lava Fire Rangeland Fence Reconstruction
- Solicitation number
- 1240LT26Q0030
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a USDA Forest Service Experience Questionnaire form used to evaluate contractor capability and qualifications for federal contract opportunities.
The questionnaire collects comprehensive information about the contractor's business background, including business structure (company, corporation, co-partnership, individual, or non-profit organization), years of experience in the relevant line of work, and experience as both prime and sub-contractors. Contractors must list projects completed within the past three years with contract amounts, project types, completion dates, and owner contact information. The form requires disclosure of all concurrent contractual commitments with dollar amounts, contract numbers, award units, percent completion, and completion dates. Contractors must answer specific questions regarding work completion failures, performance bonds, and on-the-ground site visits, with explanations required for affirmative responses. The questionnaire also requires detailed information on available employees (minimum and maximum numbers and payroll status), equipment specifications, estimated progress rates, and the experience of principal individuals directly involved in contract performance. A certification statement requires the signatory to verify accuracy of all submitted information. Additionally, the form includes a biobased products section requiring offerors to identify all biobased products to be purchased and used, specify manufacturer names, costs, intended uses, biobased content percentages, and document prior experience with biobased product specification, purchase, and installation over the past three years. All required information must also be provided for proposed subcontractors in the same format and detail level as for the primary offeror.
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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:
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 A NARRATIVE ON HOW YOU PLAN 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
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:
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate: and (2) Maximum progress rate:
Biobased Products
Offeror shall identify the biobased products to be purchased and used under this contract. For each biobased product, specify the name of the manufacturer, cost of each product, and the intended use of each of the materials that are to be used in carrying out the requirements of the contract. For each biobased product, the Offeror shall specify the percentage of biobased content, and for the USDA-designated biobased content products, the Offeror shall demonstrate that the products to be used under this contract will contain the percentage specified in the USDA recommendations or the highest level of biobased material practicable, consistent with USDA's recommended percentages of biobased content.
The Offeror shall document prior experience in specifying, purchasing, using, and installing biobased products. The Offeror shall provide a list of all relevant contracts over the past 3 years involving the specification, purchase, and/or use of biobased products. The Offeror shall include a list of the biobased products specified, purchased, used, and installed.
The above information shall be provided for all proposed subcontractors in the same format and level of detail as prescribed for the Offeror.
Page 3 EXPERIENCE QUESTIONNAIRE CONTINUED
The following is added:
Attach additional sheets, as necessary.
Page 3 EXPERIENCE QUESTIONNAIRE CONTINUED
File details come from the government source that posted it. Updated .