Past Performance Questionaire.rtf

PAST PERFORMANCE QUESTIONAIRE

INSTRUCTIONS: Contractor must identify previous federal, state, local government and or private contracts completed that are similar in size and scope to the contract being evaluated. List at least three (3) contracts for evaluation. Contracts must be either competed or current within the last (5) years. One contract reference per form. Contract must be Relevant to current requirements.

Note: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non‐NCA contracts.

Past Performance Questionnaire Contract Number

Contractor ( Name Address, Zip Code)

Telephone Number

Email Address

Type of Contract

Contract Dollar Value

Date of Award (if not completed provide status)

Type/Extent of Subcontracting

Percentage of Work completed by the Contractor

Description of Supply/Services provided, location & relevancy of work

Address, Telephone Number & Email of the Contact Person and Position

Form may be duplicated