ATTACHMENT B - Past Performance Questionaire.docx
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- Solicitation number
- 36C78620Q0326
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This combined synopsis/solicitation from the Department of Veterans Affairs National Cemetery Administration requests quotes for the supply of granite niche covers for two national cemeteries. The solicitation seeks 1,700 niche covers for delivery to Florida National Cemetery and 750 niche covers for delivery to Bay Pines National Cemetery. Quotes are due by May 8, 2020 and the contract will have a 30-day period of performance from award. The solicitation is set aside for small businesses under NAICS code 327991 with a size standard of 500 employees. Quotes will be evaluated with the award made to the responsible offeror submitting the lowest priced technically acceptable offer meeting the requirements in the statement of work, including submission of samples by the deadline.
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ATTACHMENT 4: PAST PERFORMANCE QUESTIONAIRE
INSTRUCTIONS: Offerors must identify previous federal, state, and local government and private contracts that they have completed and that are similar to the contract being evaluated. List at least five (5), for evaluation limited to the last three (3) years. (One contract reference per form, Form may be duplicated) Any subcontractors to be used shall also include three forms each.
Contractor (you) Information:
Name: _____________________________________________________________________ Address: ___________________________________________________________________ Telephone Number: ___________________________________________________________ E-mail: ______________________________________________________________________
Contract Information:
Name of company/agency you provided service for: ___________________________________ Contract Number: _____________________________________________________________ Type of Contract: _______________________________________________________________ Contract Dollar Value: ___________________________________________________________ Date of Award: _________________________________________________________________ Status: Completed, Yes____ No____ If not completed, projected completion date____________ If not completed, why?___________________________________________________________ Were you the Prime? ________ were you the Sub? _______
Point of Contact Information for the company/agency you serviced:
Name of the Contract Person & their position: ________________________________________ Address: ______________________________________________________________________ Telephone Number: _____________________________________________________________ E-mail: ________________________________________________________________________
Description of Supply/Service(s) provided, location & relevancy of work:
Complexity of Product/Service, if any:
Percentage of Work completed by your company/by subcontractor
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