Attachment B- EXPERIENCE QUESTIONNAIRE.docx
DOCX document 19 KB Posted
- Solicitation number
- 12444524Q0044
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire that requests information about the contractor's business, experience, and capabilities. The key details are:
The contractor is asked to provide information on the type of business, years of relevant experience, experience as a prime contractor or subcontractor, a list of similar projects completed in the last 3 years, current contract commitments, and whether the contractor has ever failed to complete work or had work completed by a performance bond. The contractor must also provide details on their organization structure, equipment, progress rate, and key personnel experience. Additionally, the contractor is asked to describe their GPS and shapefile experience, as well as provide their work plan for accomplishing the task. This questionnaire appears to be part of the solicitation requirements for the Hoosier National Forest Blue Creek Debris Stream Clearing project, which involves removing tornado-caused stream blockages along a 1-mile reach of Blue Creek in Martin County, Indiana.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment I- Evaluation Criteria.docx | DOCX document | |
| Attachment J- SF1449-12444524Q0044.pdf | ||
| Attachment G- Map 2.jpg | JPG image | |
| Attachment D- NRE_Commercial Services RFQ_12444524Q0044.docx | DOCX document | |
| Attachment A- PWS_QASP_Blue Creek_Debris Removal.docx | DOCX document | |
| Attachment C- Schedule of Items.docx | DOCX document | |
| Attahcment H- Map 3.pdf | ||
| Attachment F- Map 1.pdf | ||
| Attachment E- Wage Determinations.txt | TXT text file |
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Text version
EXPERIENCE QUESTIONNAIRE
1. Contractor’s Name, Address & Telephone #.
2. Type of Business
___Company ___Co-Partner ___Corporation ___Individual ___Non-profit Organization
| 3. How many years experience do you have related to this line of work? _______ years |
| 4. How many years experience as a prime contractor? ________years |
Subcontractor? _______
5. List all the similar projects your business has completed in the last three (3) years.
| CONTRACT AMOUNT |
| TYPE OF CONTRACT WORK |
| DATE COMPLETED |
| Contact Name, Address and Tele. # |
6. List all of your firms’ current contract commitments
| CONTRACT NUMBER |
| AWARD AMOUNT |
| Contact Name, Address & Tele. # |
| Percent Completed |
| Date Contract Completed |
| 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 item 7a or 7b above, specify reason(s) and location(s) why.
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: _____ | and Maximum No. of employees:_____ | ||
| b. Are employees regularly on your payroll? | ___yes | ___no |
c. Specify equipment to be used for this contract:
d. Estimate rate of progress (exp. 100 feet, 1/8 mile a day, etc…):
Minimum progress rate:____________ Maximum progress rate:____________
9. List the experience of the principal individuals of your business
| NAME |
| PRESENT POSITION |
| YRS EXP. |
| TYPE OF WORK |
10. GPS and Shapefile experience:
11. Work plan: Describe plan how to accomplish task.
TIN#__________________ Duns#_______________ CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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 | Print or Typed Name | Title | Date |
File details come from the government source that posted it. Updated .