J4 - Contractor Experience Questionaire.docx
DOCX document 18 KB Posted
- Attached to
- Dutch John Bunk House Roof Replacement Federal contract opportunity
- Solicitation number
- 1240LT24R0048
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Experience Questionnaire for a federal contract opportunity. The questionnaire requires the contractor to provide details on their company, past experience, available employees and equipment, and personnel that will work on the contract. The related federal contract opportunity is for the Dutch John Bunk House Roof Replacement project, which is a Total Small Business Set-Aside with an estimated value of less than $150,000. The work is expected to start in October 2024 and must be completed within 60 days. Contractor questions are due by August 23, 2024, and the Request for Proposal solicitation will close on August 30, 2024. The project is located in Dutch John, Utah, and a site visit is encouraged but not mandatory. The U.S. Forest Service, a civilian agency, is the contracting authority.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SF 30 1240LT24R0048 0001.pdf | ||
| 1442 - 2 RFP 1240LT24R0048 - Amended.pdf | ||
| J3 - Drawings.pdf | ||
| J1 - SOW - Specifications.pdf | ||
| J5 - Contractor Questions and Answers Template.doc | DOC document | |
| RFP - 1240LT24R0048.pdf | ||
| J2 - Wage Determinaiton.pdf |
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Text version
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) U.S Forest Service (USDA) 324 25th Street Ogden, Utah 84401-2310
3. Business [ ] Company [ ] Corporation [ ] Non-profit Organization [ ] Co-partnership [ ] Individual
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 Amount |
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:
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 Personnel to work on 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 blue ink) |
| 13. DATE |
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