Attachment_4_Past_Performance_Info.doc

Past Performance Information

Please provide THREE (3) past performance references for UHP Water Jet Blasting Services completed during the past three years (2015, 2016, and 2017) or currently in process for UHP Water Jet Blasting Services or relevant services as those being requested under this solicitation. Relevant services is defined as those services that are similar in complexity and scope as those being solicited. The government reserves the right to contact individuals and companies/agencies other than those listed on this form to collect additional past performance information. Further, any information contained in the US Government’s Past Performance Information Retrieval System (PPIRS) may also be reviewed in the evaluation of past performance.

Company Information Company Name:

Address:

Phone:

Fax:

Email:

Reference Information #1

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Reference Information #2

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Reference Information #3

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Past Performance Information Sheet