C04d_Attachment 4_Exhibit A Perform Relevancy Questionnaire_12444026Q0068.pdf
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- Attached to
- USDA-FOREST SERVICE Clinch Ranger District Mowing – George Washington-Jefferson National Forest (VA)
- Solicitation number
- 12444026Q0068
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Performance Relevancy Questionnaire template used by the U.S. Forest Service to evaluate contractor qualifications and past performance.
The questionnaire requires offerors to provide comprehensive information about their experience and capability to perform Forest Service work. Contractors must identify their firm name, address, and telephone number, and specify years of experience in their line of work and contracting history as both prime and subcontractors. Part 1 requests documentation of up to five completed projects within the past three years that are similar in scope to the solicitation, including contract amounts, project types, completion dates, and contact information for project references. Offerors must also list all concurrent contractual commitments, including contract numbers, dollar amounts, awarding agencies, percentage completion status, and projected completion dates. The questionnaire includes yes/no questions regarding failure to complete awarded work and whether performance bonds were used, with space for detailed explanations if applicable. Part 2 requires separate detailed responses for each project listed, addressing the specific work elements performed by the firm, work performed by major subcontractors and their anticipated use on Forest Service projects, technical areas uniquely relevant to the solicitation, and government contracting officer or inspector contact information including current phone numbers, facsimile numbers, and email addresses. The form concludes with a certification section requiring the certifying official's printed name, title, signature in ink, and date, with language confirming that all statements are complete and correct and that named references are authorized to provide verification of capability.
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Text version
Exhibit A: PERFORMANCE RELEVANCY QUESTIONNAIRE
Provide the following information requested in this format for each of the projects/contracts being described. Projects may be ongoing and cannot have been completed any later than 3 years prior to the to this issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. Use as much space as required. OFFEROR SHOULD PLACE
THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE.
INSTRUCTIONS: If extra space is needed use the reverse. Mark "X" in appropriate boxes.
CONTRACTOR NAME, ADDRESS & TELEPHONE
How many years do you or your firm have in the line of work contemplated by this solicitation ? How many years’ experience in contracting have you or your business had as a (a) prime contractor and/or (b) sub-contractor ?
PART 1 - PAST / CURRENT PROJECTS
List below up to 5 projects your business has completed within the last 3 years similar in scope to the solicitation:
Contract Amount Type of Project Date Completed Name Address & Telephone No. of Person to Contact for Project Information.
List below all of your firm's contractual commitments running concurrently with the work contemplated by this solicitation:
Contract No. Dollar Amount of Project
Name, Address & Phone No. of Business Govt./Agency
Awarded (Units)
Completed
Date Contract Completed
Have you ever failed to complete any work awarded to you? Yes ( ) No ( ) Has work ever been completed by performance bond? Yes ( ) No ( ) If "Yes" to either item above specify location(s) and reason(s) why:
PART 2 – SPECIALIZED EXPERIENCE – For each of the projects listed above, address the following comments on a separate sheet:
a) Describe the specific elements of the work performed by your firm.
b) Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on Forest Service projects.
c) Address any technical areas about this project you consider uniquely relevant to this solicitation.
d) Point of Contact for Owner/Government agency Contracting Officer and or inspector; include a current phone number and facsimile number. Email address is also desired.
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.
Certifying Official's Printed Name and Title Signature (In Ink) Date
File details come from the government source that posted it. Updated .