Experience Questionnaire.pdf
PDF 90 KB Posted
- Solicitation number
- 1240LN24Q0049
- 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, including years of experience, projects completed, employees, and equipment available for the contract. The key details are:
The contract opportunity is for janitorial services for the Sioux Ranger District Office in Camp Crook, SD, covering approximately 4,800 square feet of space. The contractor must be able to maintain the premises, furniture, and fixtures in a clean and sanitary condition. The contract will be awarded by the USDA Forest Service. The document does not provide any information on the response or award dates, pricing terms, set asides, or incumbents.
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Other files
| File | Type | Posted |
|---|---|---|
| Combined Synopsis Sioux.pdf |
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Text version
USDA Forest Service (1/00)
EXPERIENCE QUESTIONNAIRE
Instructions: See Box 10, 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 & 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 in contracting 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 (or currently working) where we can confirm that your company has experience in similar work.
Contract Amount
Type of Project Ongoing or
Date Completed
Name, Address, and Telephone No.
of Owner/Person to Contract for
Project Information
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:
8. Organization and work that will be available for this project:
a. (1) Minimum number of employees:__________ and a (2) Maximum number of employees:__________
b. Are employees regularly on your payroll? _____ Yes _____ No
c. Specify equipment available for this contract
9. List below the experience of the principal individuals of your business:
Individual’s Name
And City of Residence Present Position Years of
Exp.
Magnitude and Type of Work
10. Remarks—Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above questions):
11. 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
12b. Signature (Sign in Ink) 13. Date
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