Experience and Past Performance Questionnaire.docx
DOCX document 25 KB Posted
- Attached to
- USFS Redbird Ranger District Generator Installation Federal contract opportunity
- Solicitation number
- 12443925Q0013
- Issued by
- Department of Agriculture Forest Service
About this file
The Experience and Past Performance Questionnaire is a detailed form designed to capture a contractor's qualifications for the USFS Redbird Ranger District Generator Installation project. The document requires contractors to provide comprehensive information about their business, including years of experience, previous project history, current contract commitments, organizational structure, employee availability, and key personnel experience. Contractors must disclose their business type, project completion track record, and demonstrate capability to perform the generator installation services.
Key requirements include submitting a completed questionnaire that details: 1) three years of project history, 2) current contract commitments, 3) employee count and payroll status, 4) available equipment, 5) principal individuals' experience, and 6) certification of information accuracy. The form is specifically for a small business set-aside procurement under NAICS code 561210, with a business size qualification of $47.0M or less in average annual receipts. Contractors must have an active SAM registration, be technically acceptable, and provide proof of competence in related work to be considered for the Daniel Boone National Forest generator installation project involving three 22kW Generac Guardian Series generators and associated transfer switches.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SF18 and Clauses 12443925Q0013.pdf | ||
| UPDATED_Statement of Work.docx | DOCX document | |
| Attachment 2 - Installation Guidelines 60 Hz Air-Cooled Generators.pdf | ||
| 2025 Manditory Contractor Training and DOL Posters 2025.pdf | ||
| Attachment 1 Owners Manual for Automatic Transfer Switch 200A Service Entrance.pdf | ||
| Clay County KY Wage Determinations.pdf | ||
| UPDATED_Evaluation Factor Rating Descriptions and Socring Matrix.docx | DOCX document |
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Text version
EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE
Instructions: Use Item No. 10 Remarks if extra space is needed to answer any item below. Answer all items.
1. Contractor’s Name, Address & Telephone Number.
1. Type of Business
___Company ___Co-Partner ___Corporation ___Individual ___Non-profit Organization
| 3. How many years’ experience do you have in this Line of work? ____ Years |
| 4. How many years’ experience as a Prime Contractor? _____ Years |
Subcontractor? _____ Years
5. List the projects your business has completed in the last three (3) years.
| COMPANY NAME, ADDRESS , TELEPHONE NUMBER AND CONTACT PERSON |
| CONTRACT TYPE/PROJECT DESCRIPTION |
| CONTRACT AMOUNT |
| PERIOD OF PERFORMANCE/DATE COMPLETED |
1. List all of your firms’ current contract commitments.
| CONTRACT NUMBER |
| AWARD AMOUNT |
| Contact Name, Address & Telephone Number |
| Percent Completed |
| Date Contract Completed |
7a. Have you ever failed to complete any work awarded to you? ___Yes ___No
7b. Has work ever been completed by performance bond? ___Yes ___No
7c. If “Yes” to either item 7a or 7b above, specify reason(s) and location(s) why.
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: _____ | and Maximum No. of employees: _____ | ||
| b. Are employees regularly on your payroll? | ___Yes | ___No |
1. Specify equipment available for this contract:
1. Estimate rate of progress (exp. 100 feet, 1/8 mile a day, etc…):
Minimum progress rate: ____________ Maximum progress rate: ____________
9. List the experience of the principal individuals of your business
| NAME |
| PRESENT POSITION |
| YEARS EXPERIENCE |
| TYPE OF WORK |
10. REMARKS
CERTIFICATION: I certify that all of the statements made by me are complete and correct to be 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.
| __________________________ | ___________________________ | ___________________ | ______ | ||
| Signature | Print or Typed Name | Title | Date |
Duns # _______________ Tax ID# ______________ Currently Registered in SAM? [ ] Yes or [ ] No
File details come from the government source that posted it. Updated .