experience questionaire.pdf
PDF 304 KB Posted
- Attached to
- ROOF INSPECTION Federal contract opportunity
- Solicitation number
- 12444824Q0018
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire, which is a form used to provide details on a contractor's past experience and qualifications. The questionnaire requests information on the contractor's business type, years of relevant experience, list of completed projects within the last 3 years, and any issues with completing previous work. Additionally, it asks for credit references and banking information to support a responsibility determination.
The related federal contract opportunity is for a Roof Inspection requirement by the USDA Forest Service. It is a firm-fixed price contract with a base period and four option years. The work involves furnishing labor, materials, and supervision to inspect roofs semi-annually. The procurement is being conducted under simplified acquisition procedures, with an anticipated award date of August 1, 2024. Offers must be submitted by email to the specified point of contact by the due date and time.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions and Answers.docx | DOCX document | |
| Updated Statement of Work Template - FPL Roof Inspections.docx | DOCX document | |
| Sol_12444824Q0018_Amd_0001.pdf | ||
| Statement of Work Template - FPL Roof Inspections.docx | DOCX document | |
| SCA RATES.pdf | ||
| Sol_12444824Q0018.pdf |
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Text version
Solicitation Number:
Page
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 8, remarks, if extra space is needed to answer any items below.
Additional sheets may be attached.
1. Contractors Name Address Phone #
2. Type of Business __ Company __ Co-Partner __ Non-profit __ Corporation __ Individual
3. How many years’ experience do you have in this line of work ___________ Years
4. How many years’ experience as a:
Prime contractor _________________ Subcontractor _____________________
5. LIST OF PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST 3
YEARS
Note: The description of work performed should be in sufficient detail for the Government to determine what the work included. (i.e. . List the services performed and quantities involved and any other types of services or other similar work accomplished). Use of only a project title does not usually provide enough detail for the Government to make an evaluation.
Project Location:
Contract Number:
Award Amount:
Period of Performance and/or Completion Date:
Client/Company’s Name/Address:
Contact Name, Email and Telephone Number:
Description of Services (Refer to Note in No. 5):
Project Location:
Contract Number:
Award Amount:
Period of Performance and/or Completion Date:
Client/Company’s Name/Address:
Contact Name, Email and Telephone Number:
Description of Services (Refer to Note in No. 5):
Project Location:
Contract Number:
Award Amount:
Period of Performance and/or Completion Date:
Client/Company’s Name/Address:
Contact Name, Email and Telephone Number:
Description of Services (Refer to Note in No. 5):
r: 124448240018
6a. Have you ever failed to complete any work awarded to you? __ Yes __ No
6b. Has work ever been completed by performance bond? __ Yes __ No
6c If “Yes” to either item 6a or 6b specify location(s) and reason(s) why
7. Information required to complete a responsibility determination. If necessary, of the apparent successful offeror. (Additional information may be requested once a contractor is selected for award. Moreover, contractor might need to provide additional authorization from a creditor to grant access.)
Credit References
Company Name/Address
Point of Contact Telephone Number Materials/Services Provided
Banking Information
Name/Address Point of Contact Telephone Number Account Number
8. REMARKS (Additional sheets may be attached to the experience questionnaire)
CERTIFCATION: 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 information needed to verify my capability to perform this project.
Name: Title: Date:
File details come from the government source that posted it. Updated .