Attachment 2_ Past Performance.docx
DOCX document 18 KB Posted
- Attached to
- Health Insurance, US Embassy Maputo
- Solicitation number
- 19GE5021R0052
About this file
This document contains a solicitation for health insurance and life insurance services for locally employed staff at the US Embassy in Maputo, Mozambique. The Regional Procurement Support Office in Frankfurt is requesting proposals to provide these services. Offerors are invited to submit pricing using the attached Microsoft Excel spreadsheet by May 28, 2021 at 3:00pm German time. Proposals should be emailed to JacobsenW@state.gov and include the subject line "Proposal 19GE5021R0052." The solicitation instructions and representations and certifications are included as attachments for offerors to review and complete as applicable. Questions regarding the solicitation must be submitted to the point of contact by April 30.
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Other files
| File | Type | Posted |
|---|---|---|
| 19GE5021R0052 questions set two.pdf | ||
| 19GE5021R0052_0002.pdf | ||
| Updated Attachment 1_Pricing.xlsx | XLSX spreadsheet | |
| Updated Exhibit A_Employee statistics list.xlsx | XLSX spreadsheet | |
| 19GE5021R0052_00001 questions and answers.pdf | ||
| Updated Attachment 1_Pricing.xlsx | XLSX spreadsheet | |
| 19GE5021R0052_00001.pdf | ||
| Exhibit A_MAPUTO MISSION EMPLOYEE STATISTICS.pdf | ||
| Attachment 3 - Form W-14.pdf | ||
| 19GE5021R0052.Maputo.pdf | ||
| Attachment 1_Pricing.xlsx | XLSX spreadsheet |
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Text version
Solicitation No. 19GE5021R0052 Attachment 2
CONTRACT INFORMATION SHEET / EXPERIENCE LISTING
Minimum 3 – maximum 5 contracts, 1 listing per contract
Experience and Past Performance
Offeror: __________________________________
(For Joint Venture Offeror) This project experience is being provided by
Name of firm
Contract Title:
Contact Location:
Contract number:
Contract Start date: _______________________________________
Contract completion date:________________________________________
Owner of the project (to evaluate performance):
Phone number:
E-mail address:
Alternate point of contact (to evaluate performance):
Phone number:
E-mail address:
Role of the offeror on this contact (check one):
Prime Contractor joint Venture Partner
If Joint Venture, list other Joint Venture partner
If Joint Venture, state % of work that the offeror was responsible for %
Describe Contract in detail, including services that are similar to the project covered in this solicitation. Include all aspects of the Contract that will demonstrate relevancy, as described in the solicitation.
File details come from the government source that posted it. Updated .