Attachment 3 - Past Performance Information Form.docx
DOCX document 19 KB Posted
- Attached to
- USCG ABBIE BURGESS DRY DOCK REPAIRS FY21
- Solicitation number
- 70Z085-21-Q-P4505500
About this file
This solicitation requests quotations for ship repair services for the USCGC ABBIE BURGESS. The Coast Guard seeks a contractor to perform various repairs to the 175-foot buoy tender at its dry-dock facility between March 16 and June 20, 2021. Services include items listed in Attachment 1 as well as additional support work. Quotations are due by December 18, 2020 and must be submitted electronically to the points of contact provided. This is a total small business set-aside solicited as a firm fixed-price contract under FAR Parts 12 and 13.5 with a NAICS code of 336611 and small business size standard of 1,250 employees. The performance location is the contractor's dry-dock and the homeport of the vessel is in Rockland, Maine. Questions are due by December 11, 2020 and the agency is the Department of Homeland Security, Coast Guard.
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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:
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