S02 EXHIBIT A Past Performance Info Sheet for Contractors.pdf

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Attached to
Z1DA--650-CSI-3516 Renovate Upgrade Angio OR Suite Construction
Solicitation number
36C24124R0065
Issued by

About this file

This document is an EXHIBIT A: PAST PERFORMANCE INFORMATION SHEET FOR CONTRACTORS, which provides a template for contractors to submit past performance information for a federal contract opportunity.

The key details include:

  • The contractor must provide information such as contract number, project title, location, contracting officer/POC, type of contract, award and final amounts, award and completion dates, change orders, OSHA citations, and major subcontractors for each relevant project/contract.
  • This past performance information is required as part of Factor 1 for the federal contract opportunity, which has a Solicitation Number of 36C24124R0065 and is for the "Z1DA--650-CSI-3516 Renovate Upgrade Angio OR Suite Construction" project at the VA Medical Center in Providence, RI. The project is a Firm Fixed Price construction contract between $1-5 million, set aside for Service-Disabled Veteran-Owned Small Businesses, with a bid bond requirement.

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Text version

EXHIBIT A: PAST PERFORMANCE INFORMATION SHEET FOR

CONTRACTORS

Provide the following information requested in this format for each of the projects/contracts being described in Factor 1.

OFFEROR (YOUR) NAME (COMPANY/DIVISION):

CONTRACT NO:

PROJECT NO:

NAICS:

PROJECT TITLE:

LOCATION:

CONTRACTING OFFICER/POC:

PHONE NO:

E-MAIL ADDRESS:

OWNER’S PROJECT MANAGER/POC:

PHONE NO:

E-MAIL ADDRESS:

TYPE OF CONTRACT (Negotiated, Design/Build):

AWARD AMOUNT: $ FINAL AMOUNT: $

AWARD DATE:

NOTICE TO PROCEED DATE:

ORIGINAL SCHEDULED COMPLETION DATE:

ACTUAL COMPLETION DATE:

NUMBER OF CHANGE ORDERS AND REASON FOR CHANGES:

OSHA CITATIONS (If Applicable):

LIST ALL MAJOR SUBCONTRACTORS (W/POC & Phone Numbers):

File details come from the government source that posted it. Updated .