Attachment F- EXPERIENCE QUESTIONNAIRE.docx

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Mark Twain NF Poplar Bluff Ranger District Janitorial Services
Solicitation number
12444524Q0043
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This document is an Experience Questionnaire that requests information about the contractor's business, experience, and capabilities. Key details include:

The contractor must provide their name, address, telephone number, and business type (company, corporation, etc.). They must specify their years of experience related to the work, years as a prime contractor and/or subcontractor. The contractor must list similar projects completed in the last 3 years, including contract amount, type of work, and completion date. Current contract commitments must also be provided, including award amount, percent completed, and expected completion date.

The contractor must indicate if they have ever failed to complete awarded work or had work completed by a performance bond, and provide an explanation if so. The questionnaire requests details on the contractor's organization and staffing, equipment, and expected progress rates. Resumes for key personnel must be included. The contractor must also indicate their experience with GPS and shapefiles, and provide a work plan describing how they would accomplish the required tasks.

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Text version

Attachment F

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.

______________________________________________________________________________
SignaturePrint or Typed NameTitleDate

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