C04 Attachment 3 Experience Questionnaire.pdf
PDF 476 KB Posted
- Attached to
- Clear Creek RD Elevator Mtce
- Solicitation number
- 1240LP26Q0181
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a USDA Forest Service Experience Questionnaire used to evaluate contractor capability and qualifications for federal contract opportunities.
The questionnaire collects comprehensive information about the contractor's background, experience, and resources. Section 1-5 requests basic contractor identification, business structure, years of experience in the relevant line of work, and years of experience as a prime contractor versus subcontractor. Section 6 requires listing of projects completed within the last three years, including contract amount, project type, completion date, and owner contact information. Section 7 requires disclosure of all concurrent contractual commitments, including contract number, award amount, contracting entity, units awarded, percent completion, and completion date. Section 8 addresses past performance through yes/no questions regarding incomplete work, performance bonds, and site visits. Section 9 requires specification of employee availability (minimum and maximum numbers), payroll status, equipment specifications, and estimated progress rates. Section 10 requests detailed information about principal individuals directly involved in contract performance, including their names, titles, years of experience, and magnitude and type of work performed. Section 11 provides space for additional remarks and supplemental information. The form concludes with a certification section where the authorized official must sign and date the questionnaire, certifying that all statements are complete and correct and authorizing reference checks.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| C04 Attachment 2 Schedule of Items Elevator Mtce.pdf | ||
| C04 Attachment 4 Wage Determination 15-5419.txt | TXT text file | |
| C04 Elevator Mtce 1240LP26Q0181.pdf | ||
| C04 Attachment 1 SOW.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
USDA Forest Service
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, Remarks, if extra space is needed to answer any item below, Mark “X: in appropriate boxes.
1. Contractor Name, Address, and Telephone Number
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 experience have you or your business had as a (a) prime contractor ____ and/or (b) sub-contractor ____?
6. List below the 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
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:
Contract Number
Dollar Amt.
of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date Contract Complete
8a. Have you ever failed to complete any work awarded to you? [ ] Yes [ ] No 8b. Has work ever been completed by performance bond? [ ] Yes [ ] No 8c. Did you look at the project site(s) on-the-ground? [ ] Yes [ ] No 8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:
EXPERIENCE QUESTIONNAIRE CONTINUED
9. Employees and equipment that will be available for this project:
a. (1) Minimum number of employees: _____ and (2) Maximum number of employees: _____
b. Are employees regularly on your payroll: [ ] Yes [ ] No
c. Specify equipment available for this contract:______________________________________________________
d. Estimate rate of progress below (such as 2.0 acres/man/day):
(1) Minimum progress rate:________________ and (2) Maximum progress rate: _________________________
10. List below the experience of the principal individuals of your business. (Who will directly be involved in this contract?)
Individual’s Name Present Position Years of Experience
Magnitude and Type of Work
11. Remarks -- Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question.):
NOTE: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT WILL HELP EVALUATE YOUR ABILITY TO
SUCCESSFULLY COMPLETE THIS PROJECT.
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.
12a. CERTIFYING OFFICIAL’S NAME AND TITLE
b. SIGNATURE (Sign in ink) 13. DATE
File details come from the government source that posted it. Updated .