Attachment 3 - Past Performance Information Form.docx

DOCX document 19 KB Posted

Attached to
USCG_HENRY_BLAKE_DOCKSIDE_REPAIRS_FY20 Federal contract opportunity
Solicitation number
RFQ_NO_70Z085-20-Q-P4580000
Issued by
Department of Homeland Security US Coast Guard

About this file

This document contains a federal solicitation for ship repair services. The United States Coast Guard is seeking quotes to perform various dockside repairs to its 175-foot buoy tender USCGC Henry Blake from August 4 to September 15, 2020 at its homeport in Everett, Washington. The requirement is set aside for small businesses with fewer than 1,250 employees and is being solicited using FAR simplified procedures for commercial items. Quotes are due by May 15, 2020 and must be submitted electronically to the points of contact listed. The final contract will be a firm fixed price agreement subject to availability of funds.

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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 .