Attachment J Past Performance Questionnaire.pdf
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- Solicitation number
- 127EAT24Q0024
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a past performance questionnaire for federal contractors to submit references on previous relevant projects completed. It requests information on the contractor such as years of experience in the relevant line of work and in federal contracting, both as a prime contractor and subcontractor. Contractors are asked to list up to three recently completed relevant projects with details including contract amount, project type, completion date, and references from the project owner that can be contacted. The contractor must certify that all information provided is complete and correct.
The related federal contract opportunity is solicitation number 127EAT24Q0024 to provide weed control services for the Lake Fire and Sawmill Libre areas within the Angeles National Forest. The solicitation with attachments describes the need for these weed control services. The soliciting agency is the United States Department of Agriculture Forest Service.
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Text version
USDA – Forest Service
PAST PERFORMANCE QUESTIONNAIRE
(Ref. FSH 6309.31 and 41 USC 1)
INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.
1. CONTRACTOR NAME, ADDRESS, AND TELEPHONE NO.
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 of experience in contracting have you or your business had as a (a) prime contractor ____ and/or (b) sub-contractor ____?
6. List below relevant 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
7a. Have you ever failed to complete any work awarded to you? Yes No 7b. If “Yes” to Item 8a type of project and reason(s) why:
8. Remarks. Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question):
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any person named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
9a. CERTIFYING OFFICIAL’S NAME AND TITLE
b. SIGNATURE (Sign in ink) 10. DATE
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