C04_Attach 4_Experience Questionnaire.pdf
PDF 121 KB Posted
- Solicitation number
- 12443926Q0189
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for the federal contract opportunity "Curly Leaf Pondweed Early Detection" (Contract Number 12443626Q0189). The form serves as Attachment #4 to the solicitation and is designed to collect detailed information about a contractor's qualifications and capability to perform the work.
The questionnaire requires contractors to provide: business type and structure (company, corporation, co-partner, non-profit, or individual); years of experience in the line of work and as a prime contractor or subcontractor; up to three most relevant projects completed within three years of solicitation issuance, 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 of effort allocation; disclosure of any failures to complete awarded work; organizational information including minimum and maximum employee counts, payroll status, and available equipment; and the experience of principal individuals including their names, current positions, years of experience, and types of work performed. The form includes a remarks section for additional information and concludes with a certification statement requiring the signatory to attest that all provided information is complete and correct and authorizing the Forest Service to verify capability through named references.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| C04_Attach 1_Schedule of Items.pdf | ||
| C04_SF1449_12443926Q0189.pdf | ||
| C04_Part 12_12443926Q0189.pdf | ||
| C04_Attach 2_PWS.pdf | ||
| C04_Attach 3_CurlyLeafPondweed Map.pdf | ||
| C04_Attach 5_WD 2003-0288.pdf |
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Text version
Curly Leaf Pondweed Early Detection 12443626Q0189 Attachment #4
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
Curly Leaf Pondweed Early Detection 12443626Q0189 Attachment #4
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 .