Contractor Experience Questionaire.docx

DOCX document 18 KB Posted

Attached to
Attic Insulation Installation Project Federal contract opportunity
Solicitation number
1240LT23R0072
Issued by
Department of Agriculture Forest Service

About this file

This document is an Experience Questionnaire for contractors interested in the Attic Insulation Installation Project solicitation issued by the Department of Agriculture Forest Service. The questionnaire collects information on the contractor's experience, past performance, available personnel and equipment, and completion of prior work. It requests details on the contractor's years of experience in the relevant line of work, as a prime contractor and subcontractor, and lists of completed projects over the last three years along with owner references. It also asks about concurrent contractual commitments, failure to complete prior work or use of performance bonds, personnel and equipment available for the project, and experience of personnel assigned. The contractor must certify that all statements are complete and correct to the best of their knowledge.

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Statement of Work and Technical Specifications.pdf PDF
1240LT23R0072 - Attic Insulation Installation.pdf PDF
J.6 Drawings.pdf PDF
David Bacon Act WD SD20230029 - Pennington County South Dakota.pdf PDF

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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

File details come from the government source that posted it. Updated .