Attachment D- PAST PERFORMANCE QUESTIONAIRE Grounds Maintenance WNYNC.docx

PAST PERFORMANCE QUESTIONAIRE

INSTRUCTIONS: Offerors are required to demonstrate within the last (5) years, successful performance under contracts (on going or completed) that are similar in scope, magnitude, and complexity to the subject requirement. Contract information provided with referrals shall be reachable by telephone or email. If a referral cannot be reached, or the offeror’s past performance is unknown, the offeror will not be evaluated favorable or unfavorable on past performance.

Contractor must identify previous federal, state, local government and or private contracts completed that are comparable in size, complexity and scope to the contract being evaluated. List at least three (3) contracts for evaluation.

Note: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non-NCA contracts.

Past Performance Questionnaire

Contract Number

Contractor ( Name Address, Zip Code)

Telephone Number

Email Address

Type of Contract

Contract Dollar Value

Date of Award (if not completed provide status)

Type/Extent of Subcontracting

Percentage of Work completed by the Contractor

Description of Supply/Services provided, location & relevancy of work

Address, Telephone Number & Email of the Contact Person and Position

Form may be duplicated