B08_Attachment_1_Relevant_Experience_Questionnaire_doc.docx
DOCX document 33 KB Posted
- Attached to
- Repower and Overhaul Confluence Ship Federal contract opportunity
- Solicitation number
- 140F0S26Q0013
About this file
This is a Relative Experience Questionnaire template used to evaluate contractor qualifications for federal contract opportunity AG-4670-S-16-0138. The form requires contractors to provide comprehensive information about their relevant experience and capability to perform the work.
The questionnaire requests basic contractor information including business type, CAGE number, and DUNS number, followed by details about years of experience in the relevant field and experience as prime versus subcontractors. Contractors must list up to five relevant projects completed within the last three years, with each project entry requiring the contract number, award amount, client name and address, contact information, and a detailed description of work performed that specifies tasks, equipment used, and any special safety or requirements. The form includes questions regarding any failure to complete awarded work or instances where work was completed by performance bond, with space to explain circumstances if applicable. Additionally, contractors must provide information on principal individuals within their organization, including names, positions, and years of experience by work type. The form requires credit references and banking point-of-contact information for responsibility determination purposes. A certification statement must be signed by an authorized representative, confirming the accuracy of all statements provided and authorizing the Forest Service to verify capability through named references. Additional remarks or supporting documentation may be attached as needed to strengthen the submission.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140F0S26Q0013.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
AG-4670-S-16-0138
ATTACHMENT 3
RELATIVE EXPERIENCE QUESTIONNAIRE
ATTACHMENT B
RELATIVE EXPERIENCE QUESTIONNAIRE
Instructions: See Box 9, remarks, if extra space is needed to answer any item below. Additional sheets may be attached.
1. Contractors Name, Address, Telephone No., & Email
2. Type of Business _Yes:_Company __Co-Partner __Non-profit __Corporation __Individual
CAGE: DUNS:
3. How many years experience do you have in this line of work____
4. How many years experience as a prime contractor_____ subcontractor___
5. LIST OF RELATIVE PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST THREE (3) YEARS
NOTE: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e., what tasks were performed, (grounds maintenance, erosion control, mulching, forestry work performed, type of equipment used, special safety or requirements) Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________________________________________________________________________________________________________________________________________________ Contact Name and Telephone number: _______________________________ Description of Work Performed: ________________________________________________________________________________________________________________________________________________________________________________________________________________ Date completed or scheduled for completion: __Project was competed on time________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: __________________________________________________________________________________________________________________________________________________________________________________________________________________ Contact Name and Telephone number: ____________________ Description of Work Performed: ___________________________________________________________________________ Date completed or scheduled for completion: __
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________ Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________ Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________
Date completed or scheduled for completion: ______________________________________________________________
Contract Number:______________________________________ Award Amount: _________________________________ Client/Company’s Name/Address: ________________________________________________________________________ Contact Name and Telephone number: ____________________________________________________________________ Description of Work Performed: _________________________________________________________________________ Date completed or scheduled for completion: ______________________________________________________________
6a. Have you ever failed to complete any work awarded to you? __yes __ no
6b. Has work ever been completed by performance bond? __yes __ no
6. If "yes" to either item 7a or 7b specify location(s) and reason(s) why
7. List the experience of the principal individuals of your business
| INDIVIDUALS NAME |
| PRESENT POSITION |
| YRS EXP |
| TYPE OF WORK |
8. Information required to complete a responsibility determination of the apparent successful offeror. (Additional information may be requested once a contractor is selected for award.. Moreover, the contractor might need to provide additional authorization from a creditor to grant access.)
a. Credit References
| Company Name/Address |
| Point of Contact |
| Telephone number |
| Materials/Services Provided |
b. Banking Information. (please do NOT provide account information – just a point of contact and a way to reach them)
| Company Name/Address |
| Point of Contact |
| Telephone number |
9. REMARKS (Additional sheets may be attached to the experience questionnaire)
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 .