Attachment 3 - Past Performance Information Form.pdf
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- Attached to
- USCGC KATMAI BAY (WTGB 101) DD FY21
- Solicitation number
- 70Z085-21-Q-P30B5600
About this file
This document contains a past performance information form and details of a federal solicitation for dry dock repairs of a Coast Guard icebreaking tug. The solicitation seeks a contractor to provide all necessary labor, materials, services, equipment and supplies to perform various dry dock repairs of the USCGC KATMAI BAY homeported in Sault Sainte Marie, Michigan. The work must be performed in accordance with the specifications in Attachment 2 of the solicitation. Offerors must submit three completed past performance reference forms providing information about previous contracts of similar size, scope and complexity, including total contract value, period of performance, description of work performed, and details of any subcontractors utilized. The solicitation number is 70Z085-21-Q-P30B5600 and was issued by the Department of Homeland Security's United States Coast Guard.
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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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