Attachement 3 - Experience and Past Performance Form.pdf

PDF 200 KB Posted

Attached to
Water leak roof repairs B049
Solicitation number
19BE2026Q0578
Issued by

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This document is an Experience and Past Performance form template issued by the General Services Office (GSO), U.S. Department of State, as part of Solicitation Number 19BE2026Q0578. The form is included in Section 3, Solicitation Provisions, as an addendum to FAR provision 52.212-1.

The template provides a structured table for offerors to document their relevant contract experience and past performance. Offerors are required to complete columns requesting the following information for each relevant contract: customer name and address, telephone numbers for the customer's lead contract and technical personnel, contract number, a brief description of the work including responsibilities, and disclosure of any litigation currently in process or occurring within the last five years. The form contains multiple blank rows to allow offerors to list multiple past performance examples. This template serves as a means for the government to evaluate contractor qualifications and experience relevant to the solicitation.

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Solicitation Number: 19BE2026Q0578

Experience and Past Performance

Section 3, Solicitation Provisions, ADDENDUM TO 52.212-1.

Customer's name and address

Telephone numbers of customer's lead contract and technical personnel

Contract number Brief description of the work, including responsibilities

Any litigation currently in process or occurring within last 5 years

Customers name and addressRow1:
Telephone numbers of customers lead contract and technical personnelRow1:
Contract numberRow1:
Brief description of the work including responsibilitiesRow1:
Any litigation currently in process or occurring within last 5 yearsRow1:
Customers name and addressRow2:
Telephone numbers of customers lead contract and technical personnelRow2:
Contract numberRow2:
Brief description of the work including responsibilitiesRow2:
Any litigation currently in process or occurring within last 5 yearsRow2:
Customers name and addressRow3:
Telephone numbers of customers lead contract and technical personnelRow3:
Contract numberRow3:
Brief description of the work including responsibilitiesRow3:
Any litigation currently in process or occurring within last 5 yearsRow3:
Customers name and addressRow4:
Telephone numbers of customers lead contract and technical personnelRow4:
Contract numberRow4:
Brief description of the work including responsibilitiesRow4:
Any litigation currently in process or occurring within last 5 yearsRow4:
Customers name and addressRow5:
Telephone numbers of customers lead contract and technical personnelRow5:
Contract numberRow5:
Brief description of the work including responsibilitiesRow5:
Any litigation currently in process or occurring within last 5 yearsRow5:

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