Attachment_A.pdf

FEDERAL BUILDING/U.S. COURTHOUSE

MILWAUKEE, WI

PBS-Region5

47PF0018R0023

PAST PERFORMANCE REFERENCE

ATTACHMENT A

Note: In accordance with the instructions contained in the paragraph entitled Basis of Award, the offeror shall complete this form and submit as part of their proposal. Make additional copies as necessary and complete one form for each reference. Please number each sheet (e.g. 1 of 7, 2 of 7) based on the number of references that you are submitting (minimum of 3, no more than 7).

1. OFFEROR (COMPANY NAME) 2. REFERENCE # OF

3. THIS PAST PERFORANCE REFERENCE IS FOR (select one)

NOTE TO OFFEROR: The Government reserves the right to approve or disapprove any changes in key personnel and/or subcontractor proposed by the Contractor after award. (See Section 00800 for further information)

OFFEROR

PREDECESSOR COMPANY(S): IDENTIFY NAME(S) OF COMPANY(S)

KEY PERSONNEL:WHO HAVE RELEVANT EXPERIENCE - IDENTIFY NAME(S) OF KEY

PERSONNEL

SUBCONTRACTOR(S) – IDENTIFY NAME(S) OF SUBCONTRACTOR(S)

4. CONTRACT STATUS AND TYPE

CURRENT GOVERNMENT

PREVIOUS NON-GOVERNMENT

5. PROJECT NAME AND LOCATION (BUILDING, CITY, STATE)

6. CONTRACT NUMBER (IF FEDERAL GOVERNMENT CONTRACT) 7. CUSTOMER (COMPANY NAME OR GOVERNMENT AGENCY)

8. CONTACT PERSON (NAME AND TITLE) 9. CONTACT PHONE NUMBER

10. TYPE OF FACILITY (office building, courthouse, hospital, school, etc.) 11. SIZE OF PROJECT (SQUARE FOOTAGE)

12. IS THE PROJECT FOR OR SIMILAR TO HISTORIC RESTORATION?

YES NO

13. IF COMPLETED PROJECT – COMPLETED ON TIME?

YES NO (If No, explain on back)

13A. START DATE 13B. COMPLETION DATE 13C. NUMBER OF DAYS

14A. IF CURRENT PROJECT – ON SCHEDULE?

YES NO (If No, explain on back)

14B. START DATE 14C. ESTIMATED COMPLETION DATE 14D. PERCENT COMPLETED

(No less than 90%)

15. DESCRIPTION OF PROJECT AND COMPLEXITY

16. LIST WHICH ELEMENTS OF THE PROJECT WERE SUBCONTRACTED

17. PROBLEMS ENCOUNTERED AND CORRECTIVE ACTIONS TAKEN