Attachment 0003 - Work Experience Reference Sheet.pdf

204 KB Posted

Attached to
Mold Remediation Services and Environmental Testing (USAG-HI)
Solicitation number
W912CN-26-Q-A028
Issued by

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Written by GovTribe AI ·

This is a work experience information form template for the federal solicitation W912CN-26-Q-A028, which pertains to mold remediation services and independent environmental testing. The form is designed for offerors to document their relevant past performance on similar projects.

The form requires offerors to provide comprehensive details about reference contracts completed within the two years preceding the solicitation issue date. Required information includes the offeror/vendor name, customer reference contact information (name, phone, fax, email), contract number, project title, and a detailed description of the scope of work performed. Offerors must document the period of performance for the base year and up to four option years, along with corresponding contract amounts for each period. The form also requires offerors to provide a narrative explanation demonstrating how the services performed on the referenced project are relevant to the current requirement, specifically addressing the nature, scope, size, magnitude, and complexity of the work. Offerors are responsible for reproducing and submitting multiple copies of this form as needed to demonstrate their qualifications and past performance capability in mold remediation and environmental testing services.

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W912CN-26-Q-A028

ATTACHMENT 0003

WORK EXPERIENCE INFORMATION

Mold Remediation Services and Independent Environmental Testing

NOTE: The offeror is responsible for reproducing copies of this form. Limit to references within the past two (2) years preceding the solicitation issue date.

1. Offeror/Vendor Name: ________________________________________________________

2. Name of Reference/Customer: _________________________________________________________

3. Phone No.: ________________________ Fax No.: _________________

Email: _______________________________________________

3. Contract Number: _____________________________________

4. Project Title: ________________________________________

5. Brief Description of Scope of Work: ____________________________________________________

6. Period of Performance:

Base Year: ____________________________ 1st Option: ____________________________ 2nd Option: ____________________________ 3rd Option: ____________________________ 4th Option: ____________________________

7. Contract Amount:

Base Year: $ __________________ 1st Option: $ __________________ 2nd Option: $ __________________ 3rd Option: $ __________________ 4th Option: $ __________________

Total: $ __________________

8. Discuss and provide a narrative of how the services performed in this work experience information are relevant to this requirement in terms of nature, scope, size, magnitude and complexity.

OfferorVendor Name:
Name of ReferenceCustomer:
Phone No:
Fax No:
Email:
Contract Number:
Project Title:
Brief Description of Scope of Work:
5 1:
5 2:
5 3:
5 4:
5 5:
5 6:
5 7:
Base Year:
1st Option:
2nd Option:
3rd Option:
4th Option:
undefined:
undefined_2:
undefined_3:
undefined_4:
undefined_5:
undefined_6:
relevant to this requirement in terms of nature scope size magnitude and complexity 1:
relevant to this requirement in terms of nature scope size magnitude and complexity 2:
relevant to this requirement in terms of nature scope size magnitude and complexity 3:
relevant to this requirement in terms of nature scope size magnitude and complexity 4:
relevant to this requirement in terms of nature scope size magnitude and complexity 5:
relevant to this requirement in terms of nature scope size magnitude and complexity 6:
relevant to this requirement in terms of nature scope size magnitude and complexity 7:

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