Attachment 3 - Past Performance Information Form.docx

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Attached to
BARBARA MABRITY FY 2023 DRYDOCK REPAIRS
Solicitation number
70Z08522QP4501022
Issued by

About this file

This document contains a solicitation for drydock repair services for the US Coast Guard Cutter Barbara Mabry. The contractor shall provide all necessary labor, materials, equipment and services to perform drydock repairs to the 175-foot buoy tender in accordance with the specifications. Repairs may include both definite and unlisted items. This is a request for quotes that will result in a firm fixed-price contract under simplified acquisition procedures. The period of performance is from February 28, 2023 through May 9, 2023 at the contractor's facilities. Quotes are due by January 16, 2023 and award is anticipated on or around February 7, 2023. Questions regarding the solicitation are due by December 27, 2022 and shall be submitted to the points of contact listed via email.

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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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