Attachment 3 - Past Performance Information Form.docx

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Attached to
USCGC KATHERINE WALKER (WLM 552) Dockside (DS) Availability FY23
Solicitation number
70Z08523QIBCT0004
Issued by

About this file

This document contains three Past Performance Information Form templates to be filled out by offerors responding to Solicitation Number 70Z08523QIBCT0004. The solicitation is for repair availability services for the USCGC KATHERINE WALKER (WLM 552), a Coast Guard cutter, and is being issued by the Department of Homeland Security US Coast Guard. The forms require offerors to provide references and details on relevant past contracts, including customer names and contact information, contract periods of performance and extensions, descriptions of work performed, subcontractor information and values if applicable, and total contract values.

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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 .