Experience Questionaire.docx
DOCX document 17 KB Posted
- Attached to
- 2024 Apache Sitgreaves Water Wastewater Testing Federal contract opportunity
- Solicitation number
- 127EAU24Q0123
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire from the USDA Forest Service. It requests information about the contractor's company, its experience, personnel, equipment, and capability to perform the work. The questionnaire covers details such as the contractor's years of experience, previous projects, current commitments, employee and equipment resources, and progress rates. The contractor must provide this information to help the Forest Service evaluate their ability to successfully complete the project.
The related federal contract opportunity is for 2024 Apache Sitgreaves Water Wastewater Testing services. The Forest Service is seeking a contractor to provide all necessary materials, labor, supplies, supervision, equipment and incidentals to test water and wastewater samples per the Statement of Work and EPA/Arizona guidelines. The laboratory will provide written test results and invoice based on the actual testing listed on the Schedule of Items.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Wage Determination.pdf | ||
| RFQ SF1449 127EAU24Q0123.pdf | ||
| 2024 Apache-Sitgreaves Water and Wastewater Testing.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)
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 .