Past Perf.docx

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RECOVERY-Culvert Replacement - Forest Road 2160 MP 2. 4
Solicitation number
AG-0489-S-09-0061
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Past Performance Questionnaire

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Present/Past Performance Information Questionnaire

Provide present/past performance information on relevant contracts performed within the last three years for Federal agencies and commercial customers. Relevant contracts are contracts where you performed: forest road construction and repair; and/or design-build forest road construction and repair.

Provide the information requested in this form for each contract being described. Provide frank, concise comments regarding your performance on the contracts you identify. If more space is required, continue on the back of the form or on one continuation sheet.

A. Offeror name (Company/Division): _______________________________________

B. Product/Service: ______________________________________________________

C. Contract Specifics:

1. Contract Number: ________________________________________________

2. Contract Type: __________________________________________________

3. Original Contract $ Value: _________________________________________

4. Current Contract $ Value: _________________________________________

5. If Amounts for 3 and 4 above are different, provide a brief description of the reason: _________________________________________________________________

D. Completion Date:

1. Original Completion Date: _________________________________________

2. Actual Completion Date: __________________________________________

3. How many times completion date changed: ___________________________

4. Primary Causes of Completion Date change: __________________________

E. Verified Primary Customer Points of Contact: (Please provide current information on both individuals)

TechnicalContracting Officer
Name: _____________________________________________________
Office: _____________________________________________________
Address _____________________________________________________
_____________________________________________________
Telephone _____________________________________________________

F. Brief Description of Effort as ___ Prime or ___Subcontractor:

File details come from the government source that posted it. Updated .