Attachment 3 - Experience and Past Performance Form.pdf

200 KB Posted

Attached to
NEC Rail Waterproofing Membrane Repair
Solicitation number
19BE2026Q0620
Issued by

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This document is an Experience and Past Performance template issued by the General Services Office (GSO), U.S. Department of State, as part of Solicitation Number 19BE2026Q0005. The template is provided in Section J, Solicitation Provisions, as an addendum to FAR clause 52.212-1.

The template is a blank form designed for contractors to document their relevant past performance on similar contracts. It requires respondents to provide five categories of information for each previous contract: the customer's name and address, telephone numbers of the customer's lead contract and technical personnel, the 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 empty rows allowing contractors to list multiple past performance examples. This is a template document only and does not specify products, services, response dates, pricing terms, or award information.

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Solicitation Number: 19BE2026Q0005

Experience and Past Performance

Section J, 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 .