Attachment 3 - Past Performance Information Form.docx
DOCX document 19 KB Posted
- Attached to
- CGC Greenbrier Dry Dock FY 23
- Solicitation number
- 70Z08523QP230001551
About this file
This solicitation requests quotes for ship repair services for the USCGC Greenbrier. The Coast Guard requires furnishing labor, materials, equipment and other items necessary to perform dry-dock repairs including inspection, cleaning, preservation, renewal and repair of various systems and components. The work is to be performed at the contractor's facility from June 27th to September 5th, 2023. Quotes are due by March 24th with award anticipated on April 15th. The solicitation is for a firm-fixed price contract under FAR Part 12 for commercial items and FAR Subpart 13.5 simplified procedures.
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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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