Attachment_04_Questionnaire.pdf

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MAXWELL NWR ROOF
Solicitation number
140F0219R0046
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Attachment 04 – Past Performance Questionnaire

COMPANY INFORMATION

CERTIFICATION OF PAST AND PRESENT PERFORMANCE INFORMATION

Company Name:

Street Address:

City, State, Zip Code:

Dun & Bradstreet Number:

Company President:

Vice President:

Name of Survey Preparer:

Title/Position:

Date Prepared:

Signature:

CONTRACTS COMPLETED OR IN PROGRESS

Provide as few or as many references of recent and relevant projects to satisfactorily demonstrate competence with projects of similar scope and similar magnitude. References shall include point of contact, address, telephone number, project title, project value, and relevant work with similar technical requirements.

TECHNICAL DEFINITION: proven ability of offeror to meet the requirements of the

Statement of Work, Drawings, and Specifications.

RELEVANT DEFINITION: the performance being considered must have a logical connection to the work described in the solicitation. It would include such aspects as the service similarity, complexity and project magnitude.

Contract Number:

Federal Agency:

Contracting Officer Name:

- Phone Number:

- Email Address:

Contract Amount:

Project Title:

Period of Performance:

Project Location (city,state)

General Scope of Project:

Company Role:

Prime General Contractor

(select one) Subcontractor Designer Joint Venture

Describe work your company performed:

Described any subcontracted work:

Amount of Subcontracts:

Were Quality Control or Safety Issues Encountered? Describe (if any):

How were the issues resolved?

Contract Number:

Federal Agency:

Contracting Officer Name:

- Phone Number:

- Email Address:

Contract Amount:

Project Title:

Period of Performance:

Project Location (city,state)

General Scope of Project:

Company Role: Prime General Contractor (select one) Subcontractor

Designer Joint Venture

Describe work your company performed:

Described any subcontracted work:

Amount of Subcontracts:

Contract Number:

Federal Agency:

Contracting Officer Name:

- Phone Number:

- Email Address:

Contract Amount:

Project Title:

Period of Performance:

Project Location (city,state)

General Scope of Project:

Company Role: Prime General Contractor (select one) Subcontractor

Designer Joint Venture

Describe work your company performed:

Described any subcontracted work:

Amount of Subcontracts:

COMPANY INFORMATION

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