Attachment_B_-_Contractor_Information_Template.pdf

Attachment 2 - Contractor Information Template

RFQ 1305M218QNFFM0056

VESSEL DETAILS

Vessel Name:

Home Port/State:

Vessel: Permit #: Hull ID:

USCG Insp. Sticker:

Mo:

Yr:

Life raft capacity:

EPIRB: Y N Location:

Construction: Year: Shipyard:

Measurements: Length: Beam: Draft:

Tonnage: Gross: Net:

Engine: mk/model: Year: HP:

Owner/Company:

Company Contact: email:

Address:

Office Phone:

Cell Phone:

Fax Number:

Company Duns No.

CAPTAIN DETAILS

Primary Captain:

Operator #:

Yrs. as Captain:

Experience with a comparable sized vessel in estuarine and bay waters:

Secondary Captain:

(if applicable)

Operator #:

Yrs. as Captain:

Experience with a comparable sized vessel in estuarine and bay waters:

Vessel Contractor Information Template

VESSEL ELECTRONICS

Depth Sounder: Make: Model:

Description of

Radars Description of

Plotters VMS: Y N Brand: MCT/Serial:

Radios Other Electronics

(Email, Fax):

Electronic Tech.: City, ST: Phone:

VESSEL, CAPTAIN AND CREW FISHING EXPERINCE – attach additional sheet if needed

(include length of time in each fishery)

Type of Gears Used:

Areas Fished:

Max. Crew Size: (including captain)

Max. Trip Length: # Days:

Trip limitation:

fuel H2O provisions stability crew

VESSEL INSURANCE

Insurance Carrier:

Address: State: Zip:

Contact:

Phone:

List below, similar jobs, which you have successfully performed in the past, for the U.S. Government and other Companies.

Show the dollar amount opposite each contract listed.

PAST PERFORMANCE INFORMATON

Point of Contact Year Contract Amount

Government Agency

Contract Number Dollar Amount

Include Photocopies of:

- Stability Information

- Insurance Carrier Inspection/Survey

- Licenses held by Captain and Crew

- Current Insurance Policy