Experience Questionnaire.pdf

PDF 410 KB Posted

Attached to
Missoula MT Fire Cache internet cable Federal contract opportunity
Solicitation number
1240LU25Q4000
Issued by
Department of Agriculture Forest Service

About this file

The document is a USDA Forest Service Experience Questionnaire designed to gather detailed information from potential contractors for a federal contract opportunity. The form requires contractors to provide comprehensive details about their business, including years of experience, previous project history, organizational capacity, and key personnel qualifications. Specific sections include business type, contracting experience, project history, employee availability, equipment resources, and principal individuals' work experience.

The questionnaire is part of a solicitation (Solicitation Number: 1240LU25Q4000) for installing internet cable at the Fire Cache warehouse annex in Missoula, Montana. Contractors must complete the form, which asks them to verify their capability to perform the project through detailed self-reporting on past performance, current resources, and organizational structure. The form includes certification language where the contractor attests to the accuracy of the information provided and authorizes the Forest Service to verify their capability to execute the proposed work.

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Text version

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 .