Attachment 3 Past Performance Questionnaire.pdf
PDF 401 KB Posted
- Attached to
- Commercial Laundry Services Federal contract opportunity
- Solicitation number
- 127EAT24Q0066
- Issued by
- Department of Agriculture Forest Service
About this file
This document is a Past Performance Questionnaire that requests information about the contractor's relevant experience, equipment, and personnel. Key details include:
The contractor is required to provide background information on their company, including DUNS/UEI number, size status, and NAICS code. They must describe their relevant experience performing similar work, including the number of years, use of subcontractors, and references from previous clients. The contractor must list the equipment they will use and their experience with relevant equipment. They must also provide details on the key personnel who will work on the contract. Finally, the contractor must list their recent relevant past performance projects and any concurrent contractual commitments. The questionnaire must be certified by an authorized official.
View the file
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| Attachment 4 Nomex Aramid Fiber Laundering Guide.pdf | ||
| Attachment 7 Blanket Bed Wool.pdf | ||
| Attachment 5 Shirt Fire.pdf | ||
| 127EAT24Q0066 Commerical Laundry Services.pdf |
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Text version
Experience Questionnaire
1. Contractor Name, Address, Telephone Number, and Email Address:
No
2. COMPANY INFORMATION
UEI: __________________ Small Business: Yes
Primary NAICS Code: _____________
3. How many years of experience do you or your company have in performing this work? _____________
4. Will you be using a subcontractor? Yes No
5. Please provide references for the last three (3) company where you performed
Company and Name of Person Email Address/Phone # Description of Work
6. Describe the equipment you will be using in the performance of this contract:
7. What types of equipment do you have experience working with that is relevant to this contract?
8. List below the experience of the key personnel who will be performing the work:
Individual’s Name Present Position Years of Experience
Type of Work
9. Past Performance - List below the projects your business has completed within the last five (5) years that involved relevant projects of similar scope and size?
Contract Number Contract Amount Location of Work Names, Telephone No., and Email of Owner/Person to contact for Project Information
Description of Project
Contract Number Contract Amount Location of Work Names, Telephone No., and Email of Owner/Person to contact for Project Information
Description of Project
Contract Number Contract Amount Location of work Names, Telephone No., and Email of Owner/Person to contact for Project Information
Description of Project
10. List below all of your firm's contractual commitments running concurrently with the work contemplated by this solicitation:
Contract # Dollar Amount Name, Tel, Email of Business/Govt Agency Involved
Location of work When will contract be completed?
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Government with any information needed to verify my capability to perform this project.
11a. CERTIFYING OFFICIAL'S NAME AND TITLE
11b. SIGNATURE 12. DATE
| 1 Contractor Name Address Telephone Number and Email Address: |
| DUNS or UEI: |
| Primary NAICS Code: |
| 3 How many years of experience do you or your company have in performing this work: |
| 5 Please provide references for the last three 3 company where you performed: |
| Company and Name of PersonRow1: |
| Email AddressPhone Row1: |
| Description of WorkRow1: |
| Company and Name of PersonRow2: |
| Email AddressPhone Row2: |
| Description of WorkRow2: |
| Company and Name of PersonRow3: |
| Email AddressPhone Row3: |
| Description of WorkRow3: |
| 6 Describe the equipment you will be using in the performance of this contract 1: |
| 6 Describe the equipment you will be using in the performance of this contract 2: |
| undefined: |
| undefined_2: |
| 8 What types of equipment do you have experience working with that is relevant to this contract: |
| Individuals NameRow1: |
| Present PositionRow1: |
| Years of ExperienceRow1: |
| Type of WorkRow1: |
| Contract NumberRow1: |
| Contract AmountRow1: |
| Location of WorkRow1: |
| Names Telephone No and Email of OwnerPerson to contact for Project InformationRow1: |
| Description of Project: |
| Contract NumberRow1_2: |
| Contract AmountRow1_2: |
| Location of WorkRow1_2: |
| Names Telephone No and Email of OwnerPerson to contact for Project InformationRow1_2: |
| Description of ProjectRow1: |
| Description of Project_2: |
| Contract Row1: |
| Dollar AmountRow1: |
| Name Tel Email of BusinessGovt Agency InvolvedRow1: |
| Location of workRow1: |
| When will contract be completedRow1: |
| Contract Row2: |
| Dollar AmountRow2: |
| Name Tel Email of BusinessGovt Agency InvolvedRow2: |
| Location of workRow2: |
| When will contract be completedRow2: |
| Contract Row3: |
| Dollar AmountRow3: |
| Name Tel Email of BusinessGovt Agency InvolvedRow3: |
| Location of workRow3: |
| When will contract be completedRow3: |
| 13a CERTIFYING OFFICIALS NAME AND TITLE: |
| 13b SIGNATURE: |
| 14 DATE: |
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