Attachment_5-__Past_Performance_Questionnaire.pdf
PDF 81 KB Posted
- Attached to
- HAXBY 4 FENCE Federal contract opportunity
- Solicitation number
- 140L3626Q0006
About this file
This is a Past Performance Questionnaire template required to be submitted with a quote to the Bureau of Land Management. The form collects contractor information including business name, address, phone number, SAM Entity Number (UEI), and business type (company, co-partnership, corporation, individual, or non-profit organization).
The questionnaire requires contractors to disclose relevant experience in years for both the individual and company regarding the solicitation's requested work, as well as years of experience as a prime contractor and sub-contractor. Contractors must list projects completed within the last three years, including contract numbers, amounts, project types, completion dates, and reference contact information. These past projects must be relevant to the solicitation's requirements in terms of duties performed and technical complexity; irrelevant projects will not be considered. Additionally, contractors must disclose all concurrent contract commitments with names, addresses, telephone numbers, and start and finish dates. The form requires yes/no responses regarding whether work has ever failed to be completed and whether any work has been completed under performance bond, with explanations required for affirmative answers. A certification section requires the authorizing official's name, title, signature in ink, and date, certifying that all statements are complete and correct and that named references are authorized to provide verification information to the Bureau of Land Management.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140L3626Q0006_Amd_0001.pdf | ||
| Sol_140L3626Q0006.pdf | ||
| Attachment_1-_Specifications_-_Haxby_4_Fence.pdf | ||
| Attachment_2-__Maps_and_Drawings_-_Haxby_4_Fence.pdf | ||
| Attachment_3-_Price_Schedule_-_Haxby_4_Fence.pdf | ||
| Attachment_4-_Wage_Determination_Haxby_4_Fence.pdf |
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Text version
Past Performance Questionnaire
(THIS MUST BE COMPLETED AND SUBMITTED WITH YOUR QUOTE)
Contractor Name:______________________________________________________________________
Address:__________________________________ City:_______________ State: _____ Zip:________
Phone Number: ____________________ SAM Entity Number (UEI): ____________________________
Type of Business:
_____Company ____Co-partnership ______Corp._____ Individual ____Non-Profit Org.
1. How many years of RELEVENT experience do you have and/or your company have regarding the types of work requested by this solicitation?
-You__________________ -Your Company__________________
2. How many years of experience in contracting does your company have as a Prime Contractor and/or a Sub-Contractor:
-Prime_________________ -Sub-Contractor__________________
3. List below projects your business has completed within the last three years. Include the contract number and amount; the type of project; the date completed and a reference contact name and telephone number for each project.
Note: Past Projects must be relevant to the requirements of this solicitation in terms of duties performed, and the technical/complexity aspects of the duties required. Projects listed that are not relevant to this solicitation and its requirements will not be considered. (attach separate page if additional room is needed)
4. List all contract commitments you have that will run concurrently with the work requested in this solicitation. Include name, address, telephone number, start and finish date.
5. Have you ever failed to complete any work awarded to you? ______Yes _____No
6. Has work ever been completed by performance bond? ______Yes ______No
If “Yes” to either item, specify location and reason:
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 Bureau of Land Management with any information needed to verify my capability to perform this project.
Certifying Official Name and Title :
Authorized Signature (Sign in Ink):
Date:
Type of Business:
File details come from the government source that posted it. Updated .