Past Performance Eastern WA.pdf

USDA – Forest Service

EXPERIENCE QUESTIONNAIRE

(Ref. FSH 6309.31 and 41 USC 1)

INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.

1. CONTRACTOR NAME, ADDRESS, AND TELEPHONE NO.

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 in contracting 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

COMPLETED

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. If “Yes” to either item 8a or 8b specify location(s) and reason(s) why:

9. Organization and work that will be available for this project.

a. (1) Minimum number of employees: _____ and a(2) Maximum number of employees: ______ ?

b. Are employees regularly on your payroll: Yes No

c. Specify equipment available for this contract:

10. List below the experience of the principal individuals of your business:

INDIVIDUAL’S NAME

PRESENT

POSITION

YEARS

OF EXP. MAGNITUDE AND TYPE OF WORK

11. List all the equipment (ie: cranes) you plan to use on this contract.

12. List proposed team and key sub-contractors to accomplish this project

13. Remarks. Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question):

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 name 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

lsolberg Cross-Out

EVALUATION QUESTIONNAIRE (Continued)

ANSWERS ON A SEPARATE PIECE OF PAPER MUST BE RETURNED WITH

QUOTE FOR CONSIDERATION

Technical Proposal Instructions. The technical proposal will be used to make an evaluation and arrive at a determination as to whether the proposal will meet the requirements of the

Government. Therefore, the technical proposal must present sufficient information to reflect a thorough understanding of the requirements and a detailed, description of the techniques, procedures and program for achieving the objectives of the specifications/statement of work.

Proposals which merely paraphrase the requirements of the Government's specifications/statement of work, or use such phrases as "will comply" or "standard techniques will be employed" will be considered unacceptable and will not be considered further. Failure to provide this information may result in a complete rejection of your offer and not considered. As a minimum, the proposal must provide adequate information in the form of a brief narrative on each of the evaluation factors described in Section M that clearly demonstrates ability to perform the required work satisfactorily. Quoters must provide the following:

1. Past Performance: The quoters shall provide specific information of recent relevant contracts which support performance over the past three years and provide current references who can confirm your past performance. Past performance will be evaluated by Government contacting a sample of customers from the listing of past projects, review of past performance surveys received and any other source available.

For those contracts with less than positive performance, you are encouraged to provide a description of the problems and the efforts made to correct and to prevent future occurrences.

For each relevant contract or reference, the offeror is requested to provide:

Agency/Company and current point of contact and telephone number

Period of performance

Dollar value of contract

Contract number and type

Subcontractors used (If Any)

The Experience Questionnaire which is attached to this Section (Section J) may be used as the submittal format for relevant contract or reference information.

2. Technical: The offeror should provide at a minimum on a piece of paper attached to his/her quote.

(a) Technical Approach and Constructing Schedule for the Project.

Explain in detail how you would prepare the site for the job and explain your approach. Also provide a performance schedule which includes proposed dates of ordering and receiving materials, coordinating with subcontractors, and project milestones. The technical approach must provide evidence of understanding the project requirements.