Attachment 7 Experience Questionnaire.docx
DOCX document 24 KB Posted
- Solicitation number
- 1284LM26Q0011
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form used by the USDA Forest Service to evaluate contractor qualifications and capabilities for federal contract opportunities. The form requires prospective contractors to provide comprehensive information about their business background, relevant experience, project history, workforce capacity, and key personnel qualifications.
Contractors must complete detailed sections including: contractor identification and business structure; years of experience in the relevant line of work and as prime or subcontractors; a list of projects completed within the last three years with contract amounts, completion dates, and owner contact information; concurrent contractual commitments with dollar amounts and completion percentages; work completion history and site visit documentation; available employees and equipment for the project; and detailed experience of principal individuals who will be directly involved in contract execution. The form also includes specific yes/no questions regarding work completion failures, performance bonds, and on-site inspections. Respondents must certify under penalty that all statements are complete and correct, and that named references are authorized to verify their capability to perform the work. The form directs contractors to use Box 11 (Remarks section) for additional information that supports evaluation of their ability to successfully complete the project.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 3 Area Maps.pdf | ||
| Attachment 4 Summary Information Chart.xlsx | XLSX spreadsheet | |
| Attachment 5 Exhibits.pdf | ||
| Attachment 6 Wage Determination.pdf | ||
| Attachment 2 Statement of Work.docx | DOCX document | |
| Attachment 1 Solicitation Terms and Conditions.docx | DOCX document |
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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:
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:______________________________________________________
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 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.
12a. CERTIFYING OFFICIAL’S NAME AND TITLE
| b. SIGNATURE (Sign in ink) |
| 13. DATE |
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