Attachment_5-_PPQ_Phillips_Reservoirs_Repair.docx
DOCX document 28 KB Posted
- Attached to
- PHILLIPS RESERVOIRS REPAIR Federal contract opportunity
- Solicitation number
- 140L3626Q0040
About this file
This is a Past Performance Questionnaire template that contractors must complete and submit with their quote for the Phillips Reservoirs Repair solicitation (140L3626Q0040) issued by the Department of the Interior Bureau of Land Management.
The questionnaire requires contractors to provide their company information, including legal business structure, SAM Entity Number (UEI), and contact details. Contractors must document their relevant experience in years for both individual personnel and their company, as well as their history as prime contractors and subcontractors. The form requires listing of projects completed within the last three years with specific details including contract numbers, amounts, project type, completion dates, and reference contact information. Importantly, the solicitation specifies that past projects must be relevant to the Phillips Reservoirs Repair work in terms of duties performed and technical complexity; projects deemed irrelevant will not be considered. Contractors must also disclose any concurrent contract commitments, report any history of incomplete work, and identify whether work has required performance bonds. The questionnaire concludes with a certification statement in which the contractor attests to the accuracy and completeness of all provided information and authorizes the Bureau of Land Management to contact listed references to verify capability to perform the project.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140L3626Q0040_Amd_0001.pdf | ||
| Attachment_3-_Wage_Determination_Philips_Reservoirs_Repair.pdf | ||
| Attachment_4-_Price_Schedule_Phillips_Reservoirs_Repair.pdf | ||
| Attachment_2-_Drawings_Phillips_Reservoirs_Repair.pdf | ||
| Attachment_1-_Specifications_Phillips_Reservoirs_Repair.pdf | ||
| Sol_140L3626Q0040.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:
File details come from the government source that posted it. Updated .