Attachment 5 Past Performance and Experience.pdf
PDF 407 KB Posted
- Solicitation number
- 19GE5025R0064
About this file
Attachment 5 is a Contract Information Sheet / Experience Listing form for the Health Insurance for Locally Employed Staff (LES) solicitation at the U.S. Embassy in Brussels, Belgium. The two-page document is designed for offerors to provide detailed information about their past contract experience, with space to list up to 5 previous contracts demonstrating relevant work.
The form requires comprehensive details about each contract, including contract title, location, number, owner, contact information, the offeror's role (prime contractor or joint venture partner), contract amounts at award and completion, start and completion dates, and a detailed description of services. The purpose is to allow offerors to showcase their experience and performance history that relates to the current solicitation for health insurance services, enabling the government to evaluate the contractor's capabilities and past performance.
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Other files
| File | Type | Posted |
|---|---|---|
| 19GE5025R0064 0001.pdf | ||
| Questions and Answers_Brussels.pdf | ||
| Attachment 8 Exhibit B ORE Riders.pdf | ||
| Attachment 3 Form W-14 Instructions.pdf | ||
| Solicitation Letter_signed.pdf | ||
| 19GE5025R0064.pdf | ||
| Attachment 4 Claims History.pdf | ||
| Attachment 6 COR GMP Employee Statistic.xlsx | XLSX spreadsheet | |
| Attachment 2 Form W-14.pdf | ||
| Attachment 7 Exhibit A Employee Statistic.pdf | ||
| Attachment 1 Price Proposal Breakdown.xlsx | XLSX spreadsheet |
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Text version
Solicitation No. 19GE5025R0064 Attachment 5
CONTRACT INFORMATION SHEET / EXPERIENCE LISTING
Minimum 3 – maximum 5 contracts, 1 listing per contract
Section 3. Volume 2 Tab C - Experience and Past Performance
Offeror: ________________________________________________________________
(For Joint Venture Offeror) This project experience is being provided by
Name of firm
Contract Title:
Contact Location:
Contract number:
Owner of the project (to evaluate performance):
Phone number:
E-mail address:
Alternate point of contact (to evaluate performance):
Phone number:
E-mail address:
Role of the offeror on this contact (check one):
Prime Contractor joint Venture Partner
If Joint Venture, list other Joint Venture partner
If Joint Venture, state % of work that the offeror was responsible for %
Solicitation No. 19GE5025R0064 Attachment 5
Contract amount and currency at award: ______________________________________
Contract amount and currency at completion: __________________________________
(explain any difference in Contract description below)
Contract start date: _______________________________________________________
Original Contract completion date:
Actual Contract completion date: ____________________________________________ (explain any difference in Contract description below)
Describe Contract in detail, including services that are similar to the project covered in this solicitation. Include all aspects of the Contract that will demonstrate relevancy, as described in the solicitation.
File details come from the government source that posted it. Updated .