Attachment 3 - Past Performance Information Form.pdf

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FY21 DOCKSIDE REPAIR (ENGINE OVERHAUL) for USCGC MARCUS HANNA (WLM 175)
Solicitation number
70Z085-21-Q-P4503100
Issued by

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File Type Posted
Attachment 2 MARCUS HANNA (WLM 175) DS FQ1 MJW 21R0.pdf PDF
Attachment 5 - USCG Ombudsman Notice.pdf PDF
Attachment 1 MARCUS HANNA (WLM 175) DS FQ1 MJW 21ER0_BLANK.xls XLS spreadsheet
Attachment 6 MARCUS HANNA CSO FY21 JA siged-FINAL BETA-SAM.pdf PDF
MARCUS HANNA FINAL-Solicitation.pdf PDF
Attachment 4 - Request for Clarification Form.pdf PDF

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70Z085-21-Q-P4503100 FY21 DOCKSIDE REPAIR for USCGC MARCUS HANNA (WLM 175) 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:

70Z 085-21-Q-P45030000

FY21 DOCKSIDE REPAIR for USCGC PENOBSCOT BAY (WTGB- 140) 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

70Z 085-21-Q-P45030000

FY21 DOCKSIDE REPAIR for USCGC PENOBSCOT BAY (WTGB- 140) 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

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