J.4 Experience Questionnaire (3 Pages) Island Park Laundry Electrical.pdf
PDF 137 KB Posted
- Attached to
- Island Park Laundry Electrical Federal contract opportunity
- Solicitation number
- 1240LT23Q0128
About this file
This document is an experience questionnaire for solicitation number 1240LT23Q0128 for Island Park Laundry Electrical work with the Caribou-Targhee National Forest. The questionnaire collects information on the contractor's experience, past performance, equipment, personnel, and use of biobased products for evaluation. Key details include a request for the number of years of experience as a prime contractor and subcontractor, at least three past project references within the last three years including contract amounts and points of contact, current contractual commitments including awarded amounts and points of contact, certification of responses, and a list of equipment and personnel available for the project including expected production rates. The contractor must also provide information on prior use of biobased products including manufacturer names, costs, intended uses, biobased content percentages, and relevant past contracts over three years involving biobased products.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| J.3 Island Park Laundry Drawings.pdf | ||
| J.1 Wage Determination Fremont County ID20230021 08-04-2023.pdf | ||
| Island Park Laundry Electrical RFQ 1240LT23Q0128.pdf | ||
| J.2 SOW IslandParkLaundry.pdf |
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Text version
Solicitation No: 1240LT23Q0128 Island Park Laundry Electrical Caribou-Targhee National Forest
J.4 Experience Questionnaire
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:
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
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:
Biobased Products
Offeror shall identify the biobased products to be purchased and used under this contract. For each biobased product, specify the name of the manufacturer, cost of each product, and the intended use of each of the materials that are to be used in carrying out the requirements of the contract. For each biobased product, the Offeror shall specify the percentage of biobased content, and for the USDA-designated biobased content products, the Offeror shall demonstrate that the products to be used under this contract will contain the percentage specified in the USDA recommendations or the highest level of biobased material practicable, consistent with USDA's recommended percentages of biobased content.
The Offeror shall document prior experience in specifying, purchasing, using, and installing biobased products. The Offeror shall provide a list of all relevant contracts over the past 3 years involving the specification, purchase, and/or use of biobased products. The Offeror shall include a list of the biobased products specified, purchased, used, and installed.
The above information shall be provided for all proposed subcontractors in the same format and level of detail as prescribed for the Offeror.
Page 3 EXPERIENCE QUESTIONNAIRE CONTINUED
The following is added:
Attach additional sheets, as necessary.
File details come from the government source that posted it. Updated .