Att_06_P8418R0006_Relevant_Experience_Form.docx

ATTACHMENT NO. 06 Offeror: _____________________________

RFP NO. 140P8418R0006

RELEVANT EXPERIENCE AND PAST PERFORMANCE

FORM

Use this form to demonstrate your successful past experience of relevant jobs that compare favorably to the work offered in this project. Refer to the RFP Instructions for the Submission of Offers and Other Information (Section L of the Solicitation). List contracts and other pertinent work to describe how your experience is relevant to the requirements of this RFP. Use as many copies of this Form, or an equivalent, as may be required. Attach additional documents as needed.

PART I – FINANCIAL DATA

I.1 FINANCIAL DATA AS OF ________________ (date)

CURRENT ASSETS $_________________ Name of Bank: ____________________________

CURRENT LIABILITIES $_________________ Point of Contact: ____________________________

NET WORTH $_________________ Phone Number: ____________________________

PART II – EXISTING COMMITMENTS

II.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK:

PERFORMANCE PERIOD:

II.2 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

PERFORMANCE PERIOD:

PART III – PAST PERFORMANCE & RELEVANT EXPERIENCE

III.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:

III.2 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:

III.3 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:

III.4 LARGEST CONTRACT IN THE PAST THREE YEARS

CONTRACT NUMBER __________________________

CONTRACT AMOUNT __________________________

CONTRACT DATE __________________________

AGENCY/OWNER: __________________________