0040522831__Past_Experience_Reference_Form.doc

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Attached to
WI-IRON RIVER NFH-PROPANE Federal contract opportunity
Solicitation number
140F0621Q0037
Issued by
Department of the Interior Fish and Wildlife Service

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0040522831__QUESTIONNAIRE_OF_BIDDERS_RESPONSIBILITY.doc DOC document
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Attachment #2

RFQ# 140F0621Q0037

PAST EXPERIENCE & REFERENCES

REFERENCES:

This form must be completed by all quoters/bidders in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience that is pertinent to this position. Past performance and experience may be a combination of up to three contracts similar in size and complexity to those stated in the Scope of Work and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training that would enable you to better perform the work outlined in the specifications. Reference information should include a point-of-contact's name, telephone number and e-mail address.

Experience No. 1

Contract/Work type: ___________________________________________________________________________

Contract Number (if applicable): _________________________________________________________________

Total Contract Value: __________________________________________________________________________

Agency/firm for who work was performed: _________________________________________________________

Contact person at the site: Telephone #: ____________________________________________________________

E-mail address: _______________________________________________________________________________

Month/Year work began Month/Year work ended: ___________________________________________________

Brief description of duties: _

Experience No. 2

Contract/Work type: __________________________________________________________________________

Contract Number (if applicable): ________________________________________________________________

Total Contract Value: _________________________________________________________________________

Agency/firm for who work was performed: ________________________________________________________

Contact person at the site: Telephone #: ___________________________________________________________

E-mail address: ______________________________________________________________________________

Month/Year work began Month/Year work ended: __________________________________________________

Brief description of duties:

Experience No. 3

Contract Number (if applicable): ________________________________________________________________

Total Contract Value: _________________________________________________________________________

Agency/firm for who work was performed: ________________________________________________________

Contact person at the site: Telephone #: ___________________________________________________________

E-mail address: ______________________________________________________________________________

Experience No. 4

Contract Number (if applicable): ________________________________________________________________

Total Contract Value: _________________________________________________________________________

Agency/firm for who work was performed: ________________________________________________________

Contact person at the site: Telephone #: ___________________________________________________________

E-mail address: ______________________________________________________________________________

Submit NLT than the due date and time specified within this solicitation to: E-mail: mack_washingtont@fws.gov.

*NOTE: This form may also be used to assess Past Performance.

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