C04d - Experience Questionnaire - 1240LT26Q0099.docx
DOCX document 33 KB Posted
- Attached to
- UTE Look Tower Reroof Federal contract opportunity
- Solicitation number
- 1240LT26Q0099
- Issued by
- Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form used by the USDA Forest Service to evaluate contractor qualifications for the UTE Look Tower Reroof project (Solicitation Number 1240LT26Q0099) on the Ashley National Forest.
The questionnaire requires prospective contractors to demonstrate relevant experience by providing detailed information about their roofing and reroofing capabilities within the past three years, including specifics on removal and disposal of roofing systems, installation of roofing systems, metal fabrication work, and ability to meet specification requirements. Contractors must list all concurrent contractual commitments, describe employee and equipment resources available for the project, identify principal individuals who will directly manage the work, and estimate minimum and maximum rates of progress. The form also requests disclosure of any failed project completions, performance bond work, and confirmation of on-site project visits. Additionally, contractors must provide references and certify the accuracy and completeness of all submitted information. The work scope encompasses removing and disposing of existing cedar wood shingles, installing synthetic cedar shingle roofing with felt and ice shield underlayment, fabricating and installing metal flashing components, and reinstalling lightning protection systems across all four roof ridges of the historic tower structure.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| C04a - Schedule of Items - 1240LT26Q0099.pdf | ||
| C04e WD UT20260079 - 5-18-2026 1240LT26Q0099.txt | TXT text file | |
| C04 SF1442 - 1240LT26Q0099 - Final.pdf | ||
| C04f - Past Performance Data Sheet 1240LT26Q0099.docx | DOCX document | |
| C04b - Drawings - UTE TOWER - 1240LT26Q0099.pdf | ||
| C04c - SOW - SPECS- 1240LT26Q0099.pdf |
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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, SAM UEI
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 that include the roofing and/or the reroofing of facilities similar to those listed in the SOW that your business has completed within the last three years. Highlight the following factors in the Type of Project Section:
· Tell how you removed and properly disposed of roofing systems similar to that listed in the SOW.
· Tell how you installed roofing systems similar to that listed in the SOW.
· Tell how you have worked with metal fabrication for roofing requirements similar to that listed in the SOW.
· Explain your Ability to meet past project requirements according to provided specifications.
| Box # |
| Contract Amount |
| Type of Project |
| Date Completed |
| Name, Address, and Telephone No. of Owner/Person to Contact for Project Information |
6. A
6. B
6. C
6. D
6. E
6.F
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation. Explain how you have kept in contact with the entity over the contract. What were the communication methods? How did you ensure that the product is what was wanted. How was the project inspected. How have you handled disputes if any?
| 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 (This box will extend as information is added to accommodate extra space.):
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 .