Attachment 3 - Past Performance Information Form.pdf
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- Attached to
- Dry Dock (DD): USCGC HAMMER FY22 Repairs
- Solicitation number
- 70Z085-22-Q-P4502600
About this file
This solicitation requests quotes for dry dock repairs of a Coast Guard cutter. The solicitation seeks a contractor to provide all necessary labor, materials, and equipment to perform various repairs of the USCGC Hammer, a 75-foot buoy tender and barge, at the contractor's dry dock facility between January 11th and March 22nd, 2022. The requirement is set aside for small businesses with a North American Industry Classification System code of 336611 for ship repair and a small business size standard of 1,250 employees. Quotes are due by the date specified and the contract will be a firm fixed-price award subject to availability of funds. The solicitation requires contractors to provide documentation of past performance, insurance, certifications, and a list of any subcontractors in their submission.
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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:
PAST PERFORMANCE INFORMATION FORM Form ____ of ____
Name of Offeror:
Contract Number, Order
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
Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by
PAST PERFORMANCE INFORMATION FORM Form ____ of ____
Name of Offeror:
Contract Number, Order
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
Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by
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