Attachment 3 - Past Performance Information Form.docx
DOCX document 19 KB Posted
- Attached to
- USCG Harry Claiborne FY 22 - Dry Dock
- Solicitation number
- 70Z085-22-Q-P4505300
About this file
This document provides details for a solicitation to perform dry dock repairs on the US Coast Guard Cutter Harry Claiborne. The solicitation seeks a firm fixed price contract for repair services from March 15th to May 24th, 2022 at the contractor's proposed dry dock facility. Interested vendors must submit quotes by January 10th, 2022. The anticipated award date is February 15th, 2022. The requirement is set aside for small businesses with less than 1,250 employees under NAICS code 336611 for ship repair. Questions are due by December 20th, 2021 and requests for drawings close on December 17th. The solicitation is issued under FAR Part 12 and FAR Subpart 13.5 for commercial items. The 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:
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