J.5 Experience Questionnaire (2 Pages).pdf

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Attached to
Dubois Housing Roof Replacement
Solicitation number
1240LT26Q0021
Issued by

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This is a USDA Forest Service Experience Questionnaire used to evaluate contractor qualifications for the Dubois Housing Roof Replacement project (Solicitation No. 1240LT26Q0021) at the Caribou-Targhee National Forest.

The questionnaire requires contractors to provide comprehensive information about their business experience and capability to perform the work. Respondents must document their years of experience in the relevant line of work, specify whether they are operating as a company, co-partnership, corporation, individual, or non-profit organization, and detail their experience as prime contractors and/or sub-contractors. Contractors must list all projects completed within the last three years, including contract amounts, project types, completion dates, and owner contact information. Additionally, contractors must disclose all current contractual commitments running concurrently with the proposed work, including contract numbers, dollar amounts, completion percentages, and contract completion dates. The form requires disclosure of any past failures to complete awarded work or projects completed under performance bond, and confirmation of on-the-ground site visits. Contractors must also specify available employees (minimum and maximum numbers), confirm regular payroll status, list available equipment, and provide estimated rates of progress for the work. The questionnaire includes a section for detailing the experience of principal individuals who will directly work on the contract, including their names, positions, years of experience, and relevant work magnitude and type. A certification section requires the certifying official to sign and date the submission, certifying that all statements are complete and correct and authorizing the Forest Service to verify references and contractor capability.

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Other files

File Type Posted
DuboisRoofsPrebidAttendance.pdf PDF
1240LT26Q0021.0003 - Dubois Housing Roof Replacement.pdf PDF
1240LT26Q0021.0002 - Dubois Housing Roof Replacement.pdf PDF
1240LT26Q0021.0001 - Dubois Housing Roof Replacement.pdf PDF
J.4 Drawings Maps (13 Pages).pdf PDF
J.1 Wage Determinations (Clark County, ID) (Residential) (ID20260004) (01.02.2026) (5 Pages).pdf PDF
J.3 Statement of Work Specs (53 Pages).pdf PDF
1240LT26Q0021 - Dubois Housing Roof Replacement.pdf PDF
J.2 Schedule of Items.xlsx XLSX spreadsheet

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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:

Solicitation No:

Project Name:

Forest/District:

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: _________________________

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 13. DATE

2: Dubois Housing Roof Replacement
3: Caribou-Targhee National Forest
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