J.4 Experience Questionnaire (3 Pages) Island Park Sidewalk and Stairs Replacement.pdf
PDF 136 KB Posted
- Attached to
- Island Park Stairs and Sidewalk Replacement Federal contract opportunity
- Solicitation number
- 1240LT23Q0113
About this file
This document is an experience questionnaire for the Island Park Stairs and Sidewalk Replacement solicitation issued by the USDA Forest Service Region 4 Intermountain Region. The questionnaire collects information on the bidder's experience completing similar projects, available equipment and workforce, past performance issues, and use of biobased products. Bidders must provide details on relevant previous contracts over the past three years involving the specification, purchase, and installation of biobased products, including product names, manufacturers, costs, intended uses, and biobased content percentages. They must also certify that all statements are complete and correct. References may be contacted to verify the bidder's capability to perform the project.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| J.2 SOW IP SIDEWALK REPLACEMENT SPECS.pdf | ||
| Island Park Stairs and Sidewalk Replacement RFQ 1240LT23Q0113.pdf | ||
| J.3 IP Sidewalk Replacement Specs and Maps.pdf |
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Text version
Solicitation No: 1240LT23Q0113 Island Park Sidewalk and Stairs Replacement 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:
Replacement
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:
Replacement
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 .