Experience Questionaire_12444825Q0004.pdf
PDF 129 KB Posted
- Solicitation number
- 12444825Q0004
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Experience Questionnaire form for Solicitation No. 12444825Q0004 for janitorial services at NRS Parsons, WV. The form requests detailed information from potential contractors including business type (company, corporation, individual, etc.), years of experience in the work and as prime/subcontractor, and up to three relevant projects performed within the past three years.
The questionnaire requires contractors to provide current contract commitments, organizational details (minimum/maximum employees, equipment available, progress rates), and experience of principal individuals. It also includes sections for credit references and banking information (marked as N/A), and requires contractors to disclose any failed contracts or performance bond completions. The form concludes with a certification statement where contractors must attest to the accuracy of provided information. This appears to be a standard pre-award responsibility determination document used to evaluate contractor qualifications and capabilities.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Past Perf Questionnaire - 12444825Q0004.pdf | ||
| SCHEDULE OF ITEMS - WITH OPTIONS.xlsx | XLSX spreadsheet | |
| Service Contract Act WD 2015-4353.pdf | ||
| Sol_12444825Q0004_CO Signed.pdf | ||
| Parsons WV Building Map.docx | DOCX document |
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Text version
Solicitation No: 12444825Q0004 NRS Parsons, WV Janitorial
NAME, ADDRESS, E-MAIL, & PHONE NO. TO
CONTACT FOR INFORMATION.
AWARD
AMOUNT
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 11, remarks, if extra space is needed to answer any item below. Mark X in the appropriate boxes.
1. Contractors Name, Address & Telephone No. Email 2. Type of Business
Company Co-Partner Non-profit Corporation Individual
3. How many years of experience do you have in this line of work Yrs
4. How many years of experience as a prime contractor subcontractor
5. List no more than 3 most relevant projects your business has performed within 3 years of this solicitation issuance date:
CONTRACT
NUMBER
AWARD
AMOUNT
NAME, ADDRESS, E-MAIL, &
PHONE NO. TO CONTACT
FOR INFORMATION.
DATE
COMPLETED
DESCRIPTION OF
WORK PERFORMED
6. List all of your firms current contract commitments
NUMBER
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 specify location(s) and reason(s) why
PERCENT
Solicitation No: 12444825Q0004 NRS Parsons, WV Janitorial
8. Organization information available for this project:
a. Minimum # of employees: and Maximum # of employees:
b. Are employees regularly on your payroll: yes no
c. Specify equipment available for this contract:
d. Estimate rate of progress (such as 2.0 acres per day):
1. Minimum progress rate: Maximum progress rate
9. List the experience of the principal individuals of your business
INDIVIDUALS NAME PRESENT POSITION YRS EXP TYPE OF WORK
10. Information required to complete a responsibility determination if the apparent successful offeror.
a. Credit References Company Name/Address Point of Contact Telephone number TYPE OF WORK
N/A N/A N/A
b. Banking Information.
Company Name/Address Point of Contact Telephone number TYPE OF WORK
N/A N/A N/A
11. REMARKS
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:
Name: Title: Date:
File details come from the government source that posted it. Updated .