Attachment H_Experience Questionaire.pdf
PDF 394 KB Posted
- Solicitation number
- 12443926Q0069
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for Solicitation #12443926Q0069 (Silver Branch Plant Survey 3), issued by the USDA Forest Service. Contractors must submit the completed form no later than May 22, 2026 at 12:00 PM Central Time via email to Christopher Hamilton at christopher.j.hamilton@usda.gov.
The questionnaire requires contractors to provide comprehensive information about their qualifications and capacity to perform the contract work. Required submissions include: contractor name, address, telephone number, and email; business type classification (company, corporation, co-partner, non-profit, or individual); total years of experience in the line of work and experience as prime contractor versus subcontractor; detailed descriptions of up to three relevant projects completed within three years of solicitation issuance, including contract numbers, award amounts, contact information, completion dates, and work descriptions; a complete list of all current contract commitments with contract numbers, award amounts, contact information, and the percentage of effort allocated; disclosure of any failures to complete awarded work; organizational information including minimum and maximum employee counts, payroll status confirmation, and available equipment; and a detailed listing of principal individuals' names, positions, years of experience, and types of work performed. The form includes a certification section requiring the signatory to attest that all statements are complete and correct and that named references are authorized to verify the contractor's capability to perform the project.
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Text version
Solicitation # 12443926Q0069 Attachment H Silver Branch Plant Survey 3
NOTE: Please return no later than COB 22 MAY 2026 @ 1200 CT via email to Christopher Hamilton @ christopher.j.hamilton@usda.gov
NAME, ADDRESS, E-MAIL, & PHONE NO. TO
CONTACT FOR INFORMATION.
AWARD
AMOUNT
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address & Telephone No. Email 2. Type of Business
Company Co-Partner Non-profit Corporation Individual
3. How many years of experience do you have in this line of work Yrs
4. How many years of experience as a prime contractor subcontractor
5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:
CONTRACT
NUMBER
AWARD
AMOUNT
NAME, ADDRESS, E-MAIL, &
PHONE NO. TO CONTACT
FOR INFORMATION.
DATE
CONTRACT
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
CONTRACT
NUMBER
7. Have you ever failed to complete any work awarded to you? yes no
8. Organization information available for this project:
a. Minimum # of employees: and Maximum # of employees:
b. Are employees regularly on your payroll: yes no
c. Specify equipment available for this contract:
PERCENT
Solicitation # 12443926Q0069 Attachment H Silver Branch Plant Survey 3
NOTE: Please return no later than COB 22 MAY 2026 @ 1200 CT via email to Christopher Hamilton @ christopher.j.hamilton@usda.gov
9. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. REMARKS
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:
Name: Title: Date:
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