Experience Questionnaire.pdf
PDF 19 KB Posted
- Solicitation number
- 1240BE25Q0050
About this file
The document is a USDA Forest Service Experience Questionnaire designed to capture a contractor's qualifications and past performance for a potential contract. The form requires detailed information about the contractor's business, including years of experience in the relevant work, past projects completed within the last three years, current contractual commitments, employee capacity, available equipment, and key personnel experience. Contractors must provide specifics on their organizational structure, including minimum and maximum employee numbers, equipment availability, progress rates, and planned self-inspection procedures to ensure contract quality.
The questionnaire serves as a comprehensive assessment tool for the Forest Service to evaluate a contractor's capability to perform the solicited work, which in this case is janitorial services for the Quinault Office in the Pacific Ranger District. Contractors must certify the accuracy of their submitted information and authorize the Forest Service to verify their capability through reference checks. The form includes sections for detailing past contract performance, potential performance issues, and a certification statement affirming the completeness and correctness of the provided information.
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Other files
| File | Type | Posted |
|---|---|---|
| Synopsis Solicitation 1240BE25Q0050.pdf | ||
| Schedule of Items.pdf | ||
| QuinaultAdminSiteMap 1.pdf | ||
| Wage Determination 1995-0221 rev 70.pdf | ||
| PWS and QASP.pdf |
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Text version
USDA – Forest Service
EXPERIENCE QUESTIONNAIRE
(Ref. FSH 6309.31 and 41 USC 1)
INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.
1. CONTRACTOR NAME, ADDRESS, AND TELEPHONE NO.
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 of 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:
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
COMPLETED
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. If “Yes” to either item 8a or 8b specify location(s) and reason(s) why:
Previous edition is obsolete (OVER) FS-6300-27 (3/00)
9. 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:
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:
INDIVIDUAL’S NAME
PRESENT
POSITION
YEARS
OF EXP.
MAGNITUDE AND TYPE OF WORK
11. List all the equipment (including vehicles) you plan to use on this contract. Provide a detailed description of the Equipment including your maintenance plan.
12. Contractor Inspection. Describe Contractor Self Inspection Procedures which you will use to insure quality for this contract.
13. Remarks. Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question):
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any person’s name 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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