B08_Att_3_PPQ_Conserve_Edison_Desks_EDIS.pdf
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- Attached to
- EDIS CONSERVE THE EDISON DESKS
- Solicitation number
- 140P4526Q0032
About this file
Past Performance Questionnaire Summary
This is a Past Performance Questionnaire for federal contract opportunity 140P4526Q0032, EDIS Conserve the Edison Desks, issued by the National Park Service under the Department of Interior. The Point of Contact is Mary Hallmon at mary_hallmon@ios.doi.gov. The form is required for all quoters seeking consideration and must be completed and submitted to receive evaluation.
Contractors must provide comprehensive past performance information including: years of experience in the requested work type, years as a prime contractor and/or subcontractor, and detailed information on three projects completed within the last five years similar in size and complexity to the solicited work. For each project reference, contractors must supply the contract type, contract number if applicable, total contract value, performing agency/firm, contact person with telephone and email, work period dates, and a brief description of duties performed. Handwritten submissions must be legible. Additionally, contractors must certify whether they have failed to complete awarded work or required performance/payment bonds, with specification of location and reason if applicable. All statements must be certified as complete and correct by the contracting official with signature in ink. Completed forms should be returned via email to mary_hallmon@ios.doi.gov. The form also requires standard contractor information including business type classification, DUNS number, and contact details.
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140P4526Q0032
POINT OF CONTACT: MARY HALLMON mary_hallmon@ios.doi.gov EDIS Conserve the Edison Desks
Past Performance Questionnaire
Contractor Name: Duns #
Address: City: State: Zip:
Phone Number: Fax Number:
Type of Business:
_____Company ____Co-partnership ______Corp._____ Individual ____Non-Profit Org.
How many years do you or your firm has in the types of work requested by this solicitation?
_________________year(s).
How many years experience in contracting have you or your business had as a Prime Contractor? _________year(s) and/or Sub-contractor: _______(years)
List below the three (3) projects your business has completed within the last five (5) years of the proposed service requested by this solicitation, include the contract amount, the type of project, date completed and your reference contact name, address, email address and telephone number: (SEE ATTACHED SHEET)
Have you ever failed to complete any work awarded to you? ______Yes _____No
Has work ever been completed by performance/payment bond? ______Yes ______No
If “Yes” to either item, specify location and reason:
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 named as references are authorized to furnish the National Park Service with any information needed to verify my capability to perform this project.
Certifying Official Name and Title:
Signature (Sign in Ink):
Date:
PAST EXPERIENCE & REFERENCES
REFERENCES:
This form must be completed by all quoters in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience which is pertinent to this position. Past performance and experience may be a combination of up to two contracts similar in size and complexity to those stated in the Technical Provisions and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training which 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. (IF
HANDWRITTEN, MUST BE LEGIBLE)
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: ____________________________________________
Brief description of duties
Experience No. 3
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: ____________________________________________
Brief description of duties:
Return form to:
Email: mary_hallmon@ios.doi.gov
Type of Business:
File details come from the government source that posted it. Updated .