Atch 3 -Technical Evaluation.pdf

ATTACHMENT 3 - TECHNICAL FORM

Quoter’s Name: ________________________________________________________________________

Address: _________________________________________________________________________________

Quoter Point of Contact (POC) Name: ______________________________________________________

Quoter Telephone Number: _______________________________________________________________

Quoter Email:___________________________________________________________________________

Service: ________________________________________________________________________

Customer: ____________________________________________________________________

This service was performed by the named quoter as a (Circle one): Prime Contractor or Subcontractor

Place of Performance: _________________________________________________________________

Contract Number:______________________________________________________

Contract Value: ______________________________________________________________________

Contract Period or Dates of Performance: _________________________________________________

Service Description:___________________________________________________________________

Did the service include a service area of at least 100 acres: YES or NO

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________

Address: ____________________________________________________________________________

Telephone Number: ___________________________________________________________________

Email:_______________________________________________________________________________

*** Multiple Technical Forms will be accepted ****