Attachment 3 - Contractor Experience Form.pdf

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Attached to
Recreation Area Janitorial Services Coyote Valley Dam & Lake Mendocino
Solicitation number
W912P723T0003
Issued by

About this file

This document includes a solicitation for janitorial services at Coyote Valley Dam and Lake Mendocino recreational areas. The U.S. Army Corps of Engineers, San Francisco District is seeking to contract professional janitorial services, which shall include providing all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and nonpersonnel services necessary to perform janitorial services in all recreation areas. The requirement is being solicited as a Small Business Set-Aside with a NAICS code of 561720 and size standard of $22 million. The contract will be a firm-fixed-price award for an initial base year from 12 April 2023 to 11 April 2024 with two one-year option periods. Quotes are due by the date specified and must include pricing using the schedule in Attachment 4, as well as documentation of at least two years of relevant janitorial experience on the Contractor Experience Form in Attachment 3.

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Text version

SOLICITATION NUMBER: ___________________________________

PROJECT TITLE: __________________________________________________

PLEASE COMPLETE ALL REQUESTED INFORMATION

Name: _______________________________________________________ Company name: ________________________________________________ Street Address: _____________________________________________________ City: ____________________________ State: ________ Zip: _________ Phone number: ___________________________________________ DUNS: _________________________________ CAGE Code: ______________ Will you be performing this Work?

_____ Yes (list experience) _____ Yes, with help of Subcontractor (Please list experience of your firm and Subcontractor) Employee / Subcontractor’s Name: ___________________________________________ ** FAR 52.219-14 requires that at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern.

Number of Employees who will be working on this contract:

Full Time: _____________ Part Time: ___________ Seasonal: ___________ Do you and your Subcontractor have Commercial Cleaning Experience?

________ Yes Years: ____________ Months: __________ _________ No

EXPERIENCE #1

Self or Subcontractor? ___________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________ Additional Information:

EXPERIENCE #2

Self or Subcontractor? ___________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________ Additional Information:

EXPERIENCE #3

Self or Subcontractor? __________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________ Additional Information:

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