Attachment 7 - Experience Questionnaire.docx
DOCX document 38 KB Posted
- Solicitation number
- 1240LU26Q0068
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience/Past Performance Questionnaire template for the Nez Perce-Clearwater National Forest Seed Orchard Disconnect and Electrical Life Safety Rehab project (Solicitation 1240LU26Q0068), issued by the USDA Forest Service, Intermountain Zone. The questionnaire is to be submitted to Daniel Franco at the Forest Service, Property and Procurement Services.
The template requests contractor information including company name, telephone number, email address, and business type. Contractors must provide their years of experience as both prime contractors and subcontractors. The questionnaire requires documentation of three past projects, with each project entry requesting: project name and description of work performed; geographic location; contractor's role (prime or subcontractor); details on self-performance versus subcontractor utilization; performance dates; contract value; government agency/customer name; and complete contracting officer contact information (name, phone, email, and address). Additionally, contractors must disclose whether they have ever failed to complete awarded work or had work completed by performance bond, with explanations for any affirmative responses. This questionnaire serves to evaluate contractor qualifications and past performance for a small business set-aside RFQ with a quote deadline of July 22, 2026, at 12:00 P.M. Mountain Time.
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Text version
1240LU26Q0068
NEZ PERCE-CLEARWATER NATIONAL FOREST
SEED ORCHARD DISCONNECT AND ELECTRICAL LIFE SAFETY REHAB
USDA FOREST SERVICE
EXPERIENCE/PAST PERFORMANCE
QUESTIONNAIRE
| SUBMITTED TO: |
| DANIEL FRANCO |
FOREST SERVICE, PROPERTY AND PROCUREMENT SERVICES, INTERMOUNTAIN ZONE, CSA #9
CONTRACTOR NAME:
| Click or tap here to enter text. |
| TELEPHONE NUMBER: |
| Click or tap here to enter text. |
| EMAIL ADDRESS: |
| Click or tap here to enter text. |
| BUSINESS: |
| Choose an item. |
HOW MANY YEARS’ EXPERIENCE IN CONTRACTING HAVE YOU OR YOUR BUSINESS HAD AS A (A) PRIME CONTRACTOR AND/OR
(B) SUB-CONTRACTOR?
Choose an item.
Choose an item.
PROJECT 1
PROJECT NAME/TITLE:
| Click or tap here to enter text. |
| DESCRIPTION OF THE WORK PERFORMED: |
| Click or tap here to enter text. |
| GEOGRAPHIC LOCATION: |
| Click or tap here to enter text. |
| QUOTERS’ ROLE AS PRIME OR SUBCONTRACTOR: |
| Choose an item. |
| INDICATE WHETHER THE WORK WAS SELF-PERFORMED OR SUBCONTRACTORS WERE UTILIZED AND WHAT PORTION OF THE CONTRACT WAS SUBCONTRACTED: |
| Click or tap here to enter text. |
| DATES OF PERFORMANCE: |
| FROM Click or tap to enter a date. |
TO Click or tap to enter a date.
CONTRACT VALUE:
Click or tap here to enter text.
GOVERNMENT AGENCY /CUSTOMER NAME:
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER NAME: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER PHONE: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER EMAIL: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER ADDRESS: |
Click or tap here to enter text.
HAVE YOU EVER FAILED TO COMPLETE ANY WORK AWARDED TO YOU?
HAS WORK EVER BEEN COMPLETED BY PERFORMANCE BOND?
IF “YES” TO EITHER ITEM SPECIFY LOCATION(S) AND REASON(S) WHY:
| Click or tap here to enter text. |
| PROJECT 2 |
PROJECT NAME/TITLE:
| Click or tap here to enter text. |
| DESCRIPTION OF THE WORK PERFORMED: |
| Click or tap here to enter text. |
| GEOGRAPHIC LOCATION: |
| Click or tap here to enter text. |
| QUOTERS’ ROLE AS PRIME OR SUBCONTRACTOR: |
| Choose an item. |
| INDICATE WHETHER THE WORK WAS SELF-PERFORMED OR SUBCONTRACTORS WERE UTILIZED AND WHAT PORTION OF THE CONTRACT WAS SUBCONTRACTED: |
| Click or tap here to enter text. |
| DATES OF PERFORMANCE: |
| FROM Click or tap to enter a date. |
TO Click or tap to enter a date.
CONTRACT VALUE:
Click or tap here to enter text.
GOVERNMENT AGENCY /CUSTOMER NAME:
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER NAME: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER PHONE: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER EMAIL: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER ADDRESS: |
Click or tap here to enter text.
HAVE YOU EVER FAILED TO COMPLETE ANY WORK AWARDED TO YOU?
HAS WORK EVER BEEN COMPLETED BY PERFORMANCE BOND?
IF “YES” TO EITHER ITEM SPECIFY LOCATION(S) AND REASON(S) WHY:
| Click or tap here to enter text. |
| PROJECT 3 |
PROJECT NAME/TITLE:
| Click or tap here to enter text. |
| DESCRIPTION OF THE WORK PERFORMED: |
| Click or tap here to enter text. |
| GEOGRAPHIC LOCATION: |
| Click or tap here to enter text. |
| QUOTERS’ ROLE AS PRIME OR SUBCONTRACTOR: |
| Choose an item. |
| INDICATE WHETHER THE WORK WAS SELF-PERFORMED OR SUBCONTRACTORS WERE UTILIZED AND WHAT PORTION OF THE CONTRACT WAS SUBCONTRACTED: |
| Click or tap here to enter text. |
| DATES OF PERFORMANCE: |
| FROM Click or tap to enter a date. |
TO Click or tap to enter a date.
CONTRACT VALUE:
Click or tap here to enter text.
GOVERNMENT AGENCY /CUSTOMER NAME:
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER NAME: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER PHONE: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER EMAIL: |
| Click or tap here to enter text. |
| CONTRACTING OFFICER/CUSTOMER ADDRESS: |
Click or tap here to enter text.
HAVE YOU EVER FAILED TO COMPLETE ANY WORK AWARDED TO YOU?
HAS WORK EVER BEEN COMPLETED BY PERFORMANCE BOND?
IF “YES” TO EITHER ITEM SPECIFY LOCATION(S) AND REASON(S) WHY:
Click or tap here to enter text.
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