Attachment4 Experience Questionaire_1244726Q0031.pdf
PDF 138 KB Posted
- Attached to
- Broadcast Herbicide Federal contract opportunity
- Solicitation number
- 12444726Q0031
- Issued by
- Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for a federal contract solicitation (12444726Q0031) related to AGNF Broadcast Herbicide services. The form is used by the Forest Service to evaluate contractor qualifications and capability to perform the project.
The questionnaire requests comprehensive information about the bidding contractor's background and capacity, including: contractor name, address, telephone, and email; business type (company, corporation, co-partner, non-profit, or individual); years of general experience and years of experience as prime or subcontractor; up to three of the most relevant projects completed within three years of the solicitation issuance date, including contract numbers, award amounts, contact information, completion dates, and work descriptions; all current contract commitments with contract numbers, award amounts, contact information, and percentage allocation; history of work completion failures; organizational information including minimum and maximum employee counts, payroll status, and available equipment; and the experience of principal individuals including their names, present positions, years of experience, and type of work performed. The form includes a certification statement requiring the respondent to attest that all provided information is complete and correct, and authorizes the Forest Service to contact references to verify the contractor's capability to perform the project. Additional remarks space is available in Section 10 for supplementary information.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| MRD_Full_Vicinity_Map.pdf | ||
| C04_SOL_12444726Q0031_Broadcast Herbicide_v3.pdf | ||
| Questions-Answers 12444726Q0031.pdf | ||
| C04_SOL_12444726Q0031_Broadcast Herbicide_Final.pdf | ||
| C04_ Attachment_3 WD1981-0682_Rev77_13May26.pdf | ||
| C04 Attachment_ 1 Schedule Of Items (SOI).xlsx | XLSX spreadsheet | |
| C04 Attachment_ 2 Herbicide Broadcast SOW.pdf |
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Text version
12444726Q0031Attachment 04 AGNF Broadcast Herbicide
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
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
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
12444726Q0031Attachment 04 AGNF Broadcast Herbicide
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:
File details come from the government source that posted it. Updated .