Attachment_(3)__Past_Performance_Information_Form.doc

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Attached to
USCGC KISKA DRYDOCK Federal contract opportunity
Solicitation number
70Z080-18-Q-P4504400
Issued by
Department of Homeland Security US Coast Guard

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Attachment (3) Past Performance Form

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Attachment 4

PAST PERFORMANCE INFORMATION FORM
Form ___ of ___

Name of Offeror:

Contract Number, order number, or identifier:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number and e-mail address (PLEASE VERIFY):

Total dollar value for this effort including all growth work (definite and option items)

(Show either fiscal year or calendar year and dollars):

Period of Performance:
From:

To:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:

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