Attachment 3 - Past Performance Information Form.docx
DOCX document 19 KB Posted
- Attached to
- USCGC IDA LEWIS (WLM 551) DRYDOCK REPAIRS FY20
- Solicitation number
- 70Z085-20-Q-P4529800
About this file
This document includes a federal contract solicitation and past performance reference forms. The solicitation requests quotes for drydock repairs of the USCGC Ida Lewis, a 175-foot buoy tender, to be performed from April 23 to July 2, 2020 at the contractor's facilities. Services include ship repair and associated support work. The requirement is set aside for small businesses with a NAICS code of 336611 and size standard of 1,250 employees. Quotes are due under simplified procedures for commercial items and must include past performance references, certifications, and a completed SF52.212-3 commercial items representation. The homeport of the cutter is in Newport, Rhode Island. The agency is the Department of Homeland Security, United States Coast Guard.
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Text version
Attachment 3
PAST PERFORMANCE INFORMATION FORM
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact (Full Name & Title):
Customer Telephone Number and E-mail address:
(PLEASE VERIFY):
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
To:
No. of Period of Performance Time Extensions:
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:
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact
Customer Telephone Number and E-mail address:
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
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:
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact
Customer Telephone Number and E-mail address:
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
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:
File details come from the government source that posted it. Updated .