Attachment 3 - Past Performance Information Form.docx
DOCX document 19 KB Posted
- Solicitation number
- 70Z085-21-Q-P45M3900
About this file
This document contains a federal contract solicitation for ship repair services and a past performance reference form template. The solicitation seeks quotes to perform various unplanned dry dock repairs to the USCGC Hickory, a 225-foot seagoing buoy tender, from October 12-16, 2020 at the contractor's facilities. Services include ship repair and associated support work. The requirement is set aside for small businesses with a NAICS code of 336611 and size standard of 1,250 employees. Quotes are due by the response date specified in the amended solicitation and must include the past performance form, welding and insurance documentation, technical certifications, and representations and certifications. The Department of Homeland Security US Coast Guard is the contracting agency.
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Text version
Attachment 3
PAST PERFORMANCE INFORMATION FORM
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact (Full Name & Title):
Customer Telephone Number and E-mail address:
(PLEASE VERIFY):
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
To:
No. of Period of Performance Time Extensions:
Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:
Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact
Customer Telephone Number and E-mail address:
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:
Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:
Form ____ of ____
Name of Offeror:
Contract Number, Order Number, or Job identifier Reference:
Customer (Company) Reference Name & Address Location:
Customer Reference Point of Contact
Customer Telephone Number and E-mail address:
Total dollar value for this effort including all growth work (definite and option items)
(Show either each fiscal year or calendar year; and dollars):
Period of Performance (Month/Day/Year) From:
Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:
Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:
File details come from the government source that posted it. Updated .