Experience Questionnaire

USDA Forest Service

1.

Contractor Name, Address, and Telephone Number, SAM UEI

EXPERIENCE QUESTIONNAIRE

Instructions: See Box 11, Remarks, if extra space is needed to answer any item below, Mark “X: in appropriate boxes. 2. Submitted to (Office Name and Address)

3. Business

Company
Co-partnership
Corporation
Individual
Non-profit Organization
5. How many years’ experience have you or your business had as a (a) prime contractor

4. How many years do you or
your firm have in the line of work
contemplated by this solicitation?

and/or (b) sub-contractor

?

6. List below the projects that include the roofing and/or the reroofing of facilities similar to those listed in the SOW that your business has completed within the last three years. Highlight the following factors in the Type of Project Section:

Box
#

6. A

6. B

6. C

6. D

6. E

6.F

o

Tell how you removed and properly disposed of roofing systems similar to that listed in the SOW.

o

Tell how you installed roofing systems similar to that listed in the SOW.

o

Tell how you have worked with metal fabrication for roofing requirements similar to that listed in the SOW.

o

Explain your Ability to meet past project requirements according to provided specifications. 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. Explain how you have kept in contact with the entity over the contract. What were the communication methods? How did you ensure that the product is what was wanted. How was the project inspected. How have you handled disputes if any? Contract
Number

Dollar Amt.
of Award

Name, Address, and Telephone No. of
Business/Government Agency Involved

8a. Have you ever failed to complete any work awarded to you? Yes
8b. Has work ever been completed by performance bond?
Yes
8c. Did you look at the project site(s) on-the-ground?
Yes
8d. If “Yes” to either item 8a. or 8b., specify location(s) and reason(s) why:

Awarded
(Units)

Percent
Completed

Date
Contract
Complete

No
No
No

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):