ATTACHMENT 7 - EXPERIENCE QUESTIONNAIRE.docx
DOCX document 23 KB Posted
- Solicitation number
- 12444626Q0008
- Issued by
-
Department of Agriculture Forest Service
About this file
The attached document is an Experience Questionnaire for a janitorial services contract for the Chippewa National Forest's Deer River Ranger District. The form requires potential contractors to provide detailed information about their business, including years of experience, past project history, current contractual commitments, employee resources, and capabilities for performing janitorial services.
Key details include a 60-day offer validity period, requirements to disclose previous contract performance, and documentation of workforce and equipment capabilities. Contractors must list employees assigned to the project, their experience levels, and provide a narrative approach to service delivery. The document is part of a solicitation (Solicitation Number: 12444626Q0008) issued by the Department of Agriculture Forest Service for office cleaning services at the Deer River Ranger Station, with the intent of assessing contractor qualifications and readiness to perform the janitorial work.
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Text version
CHIPPEWA NF – JANITORIAL
Offer Submission Package
Experience Questionnaire (Please complete and submit the following with your offer.)
By submitting the offer, the Contractor agrees to all terms, conditions, clauses, and provisions included in the solicitation and agrees to furnish any awarded items at the price set in the schedule. The offer is valid for 60 after the closing date of the solicitation unless a formal extension is granted by the contractor.
OFFEROR NAME __________________________________________________________
OFFEROR SAM UEI NUMBER _________________________________________________
OFFEROR EMAIL ADDRESS ________________________________________________
OFFEROR POINT OF CONTACT (NAME AND PHONE) _________________________________
Instructions: See Box 10, REMARKS. If extra space is needed to answer any items below. Mark "X" in the appropriate boxes.
Please list NA for inapplicable items.
| 1. Contractor's Name, Address & Telephone Number |
| 2. Type of Business |
____ Company
____ Corporation
____ Non-profit Organization
____ Co-partner
____ Individual
3. How many years of experience do you have in this line of work? ___________________
4. How many years of experience as a prime contractor? _________ subcontractor? ________
5. List the projects your business has completed in the last 3 years.
Contract Amount
| Type of Project |
| Date |
Completed Name and Telephone Number to Contact For Information
6. List contractual commitments running concurrently with the work contemplated by this soliciation.
Contract Number Contract Amount
| Type of Project |
| Est. Date of |
Completion Name and Telephone Number to Contact For Information
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 Question 7a. or 7b., please specify location(s) and reason(s):
8. Organization that will be available for this project:
| a. | Minimum No. of employees: _______________ Maximum No. of employees: ________________ |
| b. | Are employees regularly on your payroll? ____ yes ____ no |
| c. | Specify supplies, tools, equipment (list model, horsepower, and pice size capabilities), and facilities to be used for this contract: |
d. If applicable, estimate rate of progress (such as 2.0 acres per day):
Minimum progress rate: __________________________ Maximum progress rate: _____________________
9. List the employees that would be assigned to perform janitorial services at the work site on this contract and their experience with Janitorial Services:
| Individual's Name |
| Present Position |
| Years Experience |
| Type of Work |
10. Please provide a brief narative which describes your anticipated approach to this project. The space below is not adequate for response. Please provide your response on an additional page(s).
11. Remarks: Additional pages may be added to provide additional information in this section.
CERTIFICATION: I certify that all of the statements made above 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.
Signature Title Date
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