Past_Performance.doc
DOC document 43 KB Posted
- Solicitation number
- AG-0356-S-10-0030
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Past Performance
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PAST PERFORMANCE
QUESTIONNAIRE
1. CONTRACTOR NAME, ADDRESS, & TELEPHONE NUMBER
2. BUSINESS TYPE
[ ] COMPANY
[ ] INDIVIDUAL
[ ] CORPORATION
[ ] CO-PARTNERSHIP
[ ] NON-PROFIT ORGANIZATION
3. HOW MANY YEARS DOES YOUR BUSINESS HAVE IN THE LINE OF WORK CONTEMPLATED BY THIS SOLICITATION?
4. HOW MANY YEARS EXPERIENCE IN CONTRACTING HAS YOUR BUSINESS HAD AS AN (a) PRIME CONTRACTOR __________ AND/OR (b) SUB-CONTRACTOR __________? IS THIS TIME CONCURRENT? ______
5a. LIST BELOW SIMILAR PROJECTS YOUR BUSINESS HAS COMPLETED WITHIN THE LAST THREE YEARS:
CONTRACT
AMOUNT
| TYPE OF PROJECT |
| DATE |
COMPLETED
NAME, ADDRESS & TELEPHONE NUMBER OF
OWNER/PERSON TO CONTACT FOR INFO.
5b. LIST BELOW THE PROJECTS THAT ARE INCOMPLETE:
CONTRACT
NUMBER
DOLLAR AMT.
OF AWARD
NAME, ADDRESS & PHONE NO.
OF AGENCY INVOLVED
| PERCENT COMPLETED |
| DATE |
COMPLETED
UNITS
AWARDED
6a. HAVE YOU EVER FAILED TO COMPLETE ANY WORK AWARDED TO YOU? [ ] YES [ ] NO
6b. HAS WORK EVER BEEN COMPLETED BY PERFORMANCE BOND? [ ] YES [ ] NO
6c. IF “YES” TO EITHER ITEM 6a OR 6b, SPECIFY LOCATION(S) AND REASONS(S) WHY:
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