Attachment_8_-_Past_Performance_Questionnaire.pdf

PDF 207 KB Posted

Attached to
AC Unit Installation - Honduras Federal contract opportunity
Solicitation number
19AQMM18R0139
Issued by
Department of State Office of Acquisition Management

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19AQMM18R0139 Past Performance Questionnaire

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Other files attached to AC Unit Installation - Honduras, newest first.
File Type Posted
19AQMM18R0139_0002.pdf PDF
19AQMM18R0139_QA.pdf PDF
Attachment_10_-_Submittal_Register.pdf PDF
19AQMM18R0139_0001.pdf PDF
Attachment_7_-_SUMMARY_OF_ITEMS.xlsx XLSX spreadsheet
19AQMM18R0139_B-M.pdf PDF
Attachment_2_-_AC_DRAWINGS.zip ZIP file
Attachment_5_-_ANNEX_3.xls XLS spreadsheet
Attachment_6_-_ANNEX_4.xls XLS spreadsheet
Attachment_1_-_AC_System_SOW.pdf PDF
Attachment_3_-_ANNEX_1.xlsx XLSX spreadsheet
Attachment_9_-_Firm_and_Project_Information.pdf PDF
19AQMM18R0139.pdf PDF
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Past Performance Questionnaire

1 2 3 4 5

NAME OF THE CLIENT (CONTRACTING PARTY)

CLIENT ADDRESS

CLIENT TELEPHONE NUMBER

CLIENT POINT OF CONTACT

CONTRACT NUMBER

TYPE OF CONTRACT( * 1)

NAME OF THE CONTRACT OR PROJECT

PROJECT LOCATION

PROJECT STARTING DATE

PROJECT FINISH DATE

WAS THE PROJECT FINISHED ON TIME ( Explain if needed)

SQUARE METERS OR UNITS (Indicate unit measurements)

CONTRACT COST IN USD

CONTRACT COST IN MONTHLY MINIMUM SALARIES

INDICATE IF IN THIS PROJECT YOU WERE THE PRIME

CONTRACTOR , SUBCONTRACTOR OR ASSOCIATE

INDICATE THE PERCENTAGE OF PARTICIPATION OF

YOUR FIRM IN THIS PROJECT

BRIEF DESCRIPTION OF ACTIVITIES BEING

PERFORMED

COMPARISON OF THE WORK PERFORMED WITH THIS

SOLICITATION ( *2 )

BRIEF DESCRIPTION OF TECHNICAL PROBLEMS

ENCOUNTERED AND THE WAY THEY WERE SOLVED

METHOD OF ACQUISITION (Public solicitation, private or non competed) award criteria

COST/PRICE MANAGEMENT HISTORY (any cost overruns and under runs, and cost growth and changes)

HAVE YOU HAD ANY CONTRACT TERMINATIONS IN

THE LAST FOUR (4) YEARS?

REASONS FOR TERMINATIONS (for contractor convenience, for default or other)

I certify that the information is accurate and verifiable

Signature of the Legal Representative Date Name of the Legal Representative Id Number

Artículo 289 del Código Penal Colombiano: “El que falsifique documento privado que pueda servir de prueba, incurrirá, si lo usa, en prisión de uno (1) a seis (6) años .”

(*2) En here you should indicate which activities performed are similar to the work being contracted.

Indicate the experience of the firm in similar projects performed in the last four (4) years. Include maximum 10 projects. Do not include certifications or contract copies. In the case we needed we will require it afterwards.

(*1)Consulting, construction, design, work oversight, delegated administration If you are not a company explain if you were the superintendent, director or other.

"FIRM EXPERIENCE"

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