Contractor Experience Questionaire.docx
DOCX document 18 KB Posted
- Attached to
- Parking Lot Crack & MicroSeal Project Federal contract opportunity
- Solicitation number
- 1240LT23R0067
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire for contractors interested in the Parking Lot Crack & MicroSeal Project solicitation issued by the Department of Agriculture Forest Service. The questionnaire collects information on the contractor's experience including years in business, past projects of similar scope completed within the last three years, current contractual commitments, personnel experience, equipment available, and estimated rate of progress. It requests details on failures to complete prior work and performance bond claims. Contractors must certify that all statements are complete and correct to the best of their knowledge and authorize references to be contacted to verify their capability to perform the project.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1240LT23R0067 0002 Modification.pdf | ||
| SF30 1240LT23R0067 Modification 0001.pdf | ||
| SOW - Parking Lot Crack and Microseal Project.pdf | ||
| Davis-Bacon Act WD NV20230021 - Heavy - White Pine County NV.pdf | ||
| Drawings - Parking Lot Crack and Microseal Project.pdf | ||
| Contractor Questions and Answers.doc | DOC document | |
| RFQ 1240LT23R0067.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
2. Submitted to (Office Name and Address) U.S Forest Service (USDA) 324 25th Street Ogden, Utah 84401-2310
3. Business [ ] Company [ ] Corporation [ ] Non-profit Organization [ ] Co-partnership [ ] Individual
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 Amount |
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 Personnel to work on 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 blue ink) |
| 13. DATE |
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