J5 - Contractor Experience Questionaire.docx

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Baker Draw Designated Shooting Area Shade Structure Installation
Solicitation number
1240LT24R0052
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This document is an Experience Questionnaire for a federal contract opportunity. The questionnaire requests information from the contractor about their company, experience, personnel, equipment, and ability to successfully complete the project. The related federal contract opportunity is for the Baker Draw Shooting Area Shade Structure Installation, a small business set-aside project valued at less than $50,000. The contract requires the contractor to provide all materials, labor, equipment, and other incidentals to complete the project within 60 days after the Notice to Proceed, no later than September 1, 2025. Offerors are urged to inspect the site, and contractor questions are due by August 23, 2024. The Request for Proposal solicitation will close on September 1, 2024. The contracting agency is the U.S. Forest Service under the Department of Agriculture.

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U.S FOREST SERVICE (USDA)

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

File details come from the government source that posted it. Updated .