Experience Questionnaire.pdf

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Attached to
Lone Mt Seed Orchard Vault Toilet
Solicitation number
1240LU25Q0006
Issued by

About this file

The document is a USDA Forest Service Experience Questionnaire designed to collect detailed information from potential contractors for the Lone Mt Seed Orchard Vault Toilet project. The questionnaire requires contractors to provide comprehensive details about their business, including years of experience, past project history, organizational capacity, and key personnel qualifications. Contractors must specify their business type (company, co-partnership, corporation, individual, or non-profit), document previous contract experience as prime or sub-contractors, and list projects completed within the last three years.

Key sections of the form require contractors to disclose their workforce capacity (minimum and maximum employees), available equipment, and principal individuals' professional experience. The document also includes sections for reporting past contract performance, such as whether the contractor has ever failed to complete a project or required a performance bond. Contractors must certify the accuracy of their statements and provide contact information for project references. This questionnaire will help the USDA Forest Service evaluate a contractor's capability to successfully complete the vault toilet installation project located approximately 20 miles north of Coeur d'Alene, Idaho, with an estimated project value between $25,000 and $100,000.

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Other files

File Type Posted
Lone Mtn Toilet Replacement_Construction Specs.docx DOCX document
Wage Determinations id112.pdf PDF
1240LU25Q0006 Lone Mt Vault Toilet.pdf PDF
Lone Mtn Toilet Replacement_PWS.docx DOCX document

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USDA Forest Service

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, email Address, and phone number

2. Submitted to (Office Name & Address) 3. Business type 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

Person to Contact for Project Information include email or phone #

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:

Forest Service PPS 1019 N 5th St Custer, SD 57730

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

File details come from the government source that posted it. Updated .