Attachment 3 - Past Performance Information Form.docx

DOCX document 19 KB Posted

Attached to
USCGC OSAGE and Barge dock side
Solicitation number
70Z08523QIBCT0101
Issued by

About this file

This solicitation requests quotes for dockside repair services for a Coast Guard cutter and barge. The services include various repairs and support work to be completed over a 35-day period from May 9 to June 13, 2023 at the cutter's home pier in Sewickley, Pennsylvania. Quotes are due by January 9, 2023 and the award is anticipated to be made on or around March 10, 2023. This is a set-aside for Service Disabled Veteran Owned Small Businesses and the contract type will be firm fixed price. The solicitation includes attachments detailing the scope of work and questions should be submitted by January 4.

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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 .