Relevant Experience Input Form.docx

OFFEROR’S RELEVANT EXPERIENCE INPUT FORM

1. List below your experience (indicating whether as a contractor or subcontractor) with management and performance of Janitorial services.

Your name and phone number: ___________________________________________

a. Contract Title and Number

b. Performance Date(s) (inclusive From-To)

c. Role (indicate either contractor or subcontractor)

d. Contracting Agency and Location

e. Geographic Location(s) of Work

f. Firm Fixed Price Annual Value $

g. Indefinite Quantity/Indefinite Delivery Avg. Annual Value $

h. Types and Quantities of Janitorial Services (types and sq ft of facilities maintained)

i. Points of Contact, whom the Government may contact to obtain Relevant Experience information concerning the above contract:

1) CONTRACTING OFFICER’s Name/Title/Telephone/Email

2) CONTRACT TECHNICAL MANAGER (i.e., COR/COTR/FSCM) Name/Title Telephone/Email