C04i Experience Questionnaire 1240LT26Q0137.docx
DOCX document 39 KB Posted
- Attached to
- Lucky Peak Nursery New Greenhouse
- Solicitation number
- 1240LT26Q0137
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire for the USDA Forest Service solicitation 1240LT26Q0137, a Request for Quotation (RFQ) for construction work at the Lucky Peak Nursery in Boise, Idaho. The questionnaire is designed to evaluate contractor capability and experience prior to award. Contractors must provide company information including business structure, years of experience in the relevant line of work, and history as prime or subcontractors. The form requires detailed documentation of similar projects completed within the last three years, specifically highlighting experience with demolition and reconstruction of facilities, timber frame construction, steel structure assembly, electrical service and controls, HVAC and plumbing, reinforced concrete, and asphalt work. Contractors must also demonstrate experience staging work around continued facility use and provide estimated project schedules with realistic timing and logical sequencing.
Additional sections require contractors to list all concurrent contractual commitments, explain communication methods and project inspection procedures, and disclose any history of incomplete work or performance bonds. Contractors must identify available employees and equipment, estimate rates of progress, and provide detailed experience of principal individuals who will directly manage the contract. The form includes certification requirements where the contractor must attest that all statements are complete and correct. Responses should be submitted to Tony Taylor at the USDA Forest Service, Kentucky office, with references authorized to verify the contractor's capability to perform the project.
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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 Email, SAM UEI.
2. Submitted to (Office Name and Address) Tony Taylor – tony.taylor@usda.gov
| 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 demolition and reconstruction 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: Comment by Taylor, Tony - FS, KY: Box 11. on page three may be used to elaborate. Identify in box 11 which project is being elaborated on.
Ex: 6. A - Excess material was properly disposed on this project by …
6. B - The requirements in this project’s specifications were met by ensuring ...
A. Show your experience as a prime, sub, or general contractor in the construction of structures similar in complexity including management of multiple subcontractors for the following:
· Timber frame construction
· Steel structure assembly
· Electrical service and controls
· HVAC and plumbing
· Reinforced concrete
· Asphalt
B. Show your experience with staging work around continued facility use by the occupant while construction occurs.
C. Provide an estimated project schedule with realistic timing and logical sequencing.
| 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
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. Comment by Taylor, Tony - FS, KY: Example for elaboration of projects listed in Box 6:
6. A - Excess material was properly disposed on this project by …
6. B - The requirements in this project’s specifications were met by ensuring ...
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge, and that any person 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 (Digital / Ink) |
| 13. DATE |
File details come from the government source that posted it. Updated .