Past_Experience_Questionnaire.pdf

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Attached to
Rice Trunk Replacement on Combahee Fields Unit (Er
Solicitation number
140FC124R0031
Issued by

About this file

This document contains a past experience questionnaire for contractors to complete for evaluation purposes related to a federal solicitation. The solicitation is for rice trunk replacement on Combahee Fields Unit of the Ernest F. Hollings ACE Basin National Wildlife Refuge. Offerors must provide details on up to five past projects, including descriptions, contract amounts, owners, dates, whether they served as a prime contractor or subcontractor, any modifications or time extensions, disputes, and defaults. The Department of the Interior Fish and Wildlife Service is the contracting agency, and responses are required for evaluation to support the solicitation for rice trunk replacement work at the specified national wildlife refuge location.

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PAST EXPERIENCE QUESTIONNAIRE

(Offerors must complete this form for evaluation purposes)

NAME OF FIRM POINT OF CONTACT

TELEPHONE NO.

EMAIL ADDRESS OR FAX

NO.

PRIOR PROJECT EXPERIENCE

(TO BE COMPLETED BY THE OFFEROR - LIST UP TO FIVE (5) INDIVIDUAL PROJECTS)

PROJECT DESCRIPTION

(USE BLANK PAGE IF NECESSARY)

CONTRACT/PROJECT

NO.

LOCATION

CONTRACT AMOUNT (ROUND

TO NEAREST DOLLAR)

ORIGINAL FINAL

1.

2.

3.

4.

5.

NAME OF OWNER/AGENCY POINT OF CONTACT TELEPHONE NO. FACSIMILE NO.

1.

2.

3.

4.

5.

ORIGINAL PROJECT DATES

WERE YOU A PRIME CONTRACTOR

OR SUBCONTRACTOR?

WERE THERE

CONTRACT

MODIFICATIONS?

(YES/NO)

HOW MANY?

WHO INITIATED

THEM? CLIENT OR

CONTRACTOR? START COMPLETION

1.

2.

3.

4.

5.

WERE THERE ANY

TIME EXTENSIONS?

(YES/NO)

IF SO, INDICATE

TOTAL EXTENDED

DAYS?

WAS THE

SCHEDULE MET?

(YES/NO)

IF NOT, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

1.

2.

3.

4.

5.

HAVE YOU EVER

ENTERED A

DISPUTE? (YES/NO)

IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

HAVE YOU EVER

BEEN DEFAULTED?

(YES/NO)

IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

1.

2.

3.

4.

5.

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