Experience Questionnaire.docx
DOCX document 48 KB Posted
- Solicitation number
- 1284LM25Q0024
- Issued by
-
Department of Agriculture Forest Service
About this file
The document is an Experience Questionnaire from the USDA Forest Service for a federal contract opportunity related to fertilizer application for hayfields. The solicitation (Number 1284LM25Q0024) is a 100% small business set-aside procurement for fertilization services at Ninemile Ranger Station in Lolo National Forest, to be evaluated using the Lowest Price Technically Acceptable method. Key administrative details include a question submission deadline of April 15, 2025 at 1700 MST, and a quote submission deadline of April 29, 2025 at 1700 MST, with quotes to be sent to Contract Specialist Sarah Cotton at sarah.cotton@usda.gov.
The Experience Questionnaire requires potential contractors to provide detailed information about their business, including years of experience, past project history, current contractual commitments, equipment availability, employee capacity, and key personnel qualifications. Contractors must certify the accuracy of their submitted information and are asked to provide comprehensive details that demonstrate their capability to successfully complete the fertilization project, with sections covering business type, prior contracting experience, project references, and a certification of information accuracy.
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Other files
| File | Type | Posted |
|---|---|---|
| Wage Determinations 2015-5393 Rev 24 dated 23 December 2024 (Lolo).pdf | ||
| 1284LM25Q0024.pdf | ||
| Statement of Work.pdf |
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Text version
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 principal individuals of your business. (Who will directly be involved in 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 ink) |
| 13. DATE |
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Microsoft_Word_Document.docx
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 [ ] Co-partnership
[ ] Corporation [ ] Individual
[ ] Non-profit Organization
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 Amt. 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 principal individuals of your business. (Who will directly be involved in 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 ink)
13. DATE
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