B08_10_Experience_and_Past_Performance_Form.pdf

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Attached to
IDIQ- HAZARDOUS WASTE Federal contract opportunity
Solicitation number
140P8625Q0014
Issued by
Department of the Interior National Park Service

About this file

This document is an Experience and Past Performance Form (Form 1) for Request for Quote (RFQ) No. 140P8625Q0014, designed for potential contractors to demonstrate their qualifications for a hazardous waste management and disposal services contract. The form requires offerors to provide detailed information across three parts: financial data, existing commitments, and past performance/relevant experience.

The form solicits comprehensive details including current assets, liabilities, net worth, contract history, and specifics about previous projects involving hazardous waste management and emergency response services within the last three years. Contractors must list up to four contract experiences, including contract numbers, amounts, agency/owners, contact persons, work descriptions, and performance periods. The final section asks for information about the largest contract completed in the past three years, providing an opportunity for vendors to showcase their most significant relevant work and organizational capabilities.

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Text version

Offeror: _____________________________ RFQ No. 140P8625Q0014 Attachment No. 10

FORM 1

EXPERIENCE AND PAST PERFORMANCE

Use this form to demonstrate your successful past experience of relevant jobs that compare favorably to the work offered in this project. Refer to the Instructions to Offerors, Award Selection Process, and 52.212-2

Evaluation – Commercial Products and Commercial Services. List jobs of similar nature/scope as performed within the last three years. Use as many copies of this Form, or an equivalent, as may be required. Attach additional documents as needed.

PART I – FINANCIAL DATA

I.1 FINANCIAL DATA AS OF ________________ (date)

CURRENT ASSETS $_________________ Name of Bank: _________________

CURRENT LIABILITIES $_________________ Point of Contact: _________________

NET WORTH $_________________ Phone Number: _________________

PART II – EXISTING COMMITMENTS

II.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A LIST OF JOBS FOR , PROVIDING HAZARDOUS WASTE

MANAGEMENT AND DISPOSAL SERVICES AS WELL AS EMERGENCY RESPONSE SERVICES

MAJOR PROJECT TASKS, ETC):

PERFORMANCE PERIOD:

Offeror: _____________________________ RFQ No. 140P8625Q0014

II.2 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A LIST OF JOBS FOR , PROVIDING HAZARDOUS WASTE

MANAGEMENT AND DISPOSAL SERVICES AS WELL AS EMERGENCY RESPONSE SERVICES

MAJOR PROJECT TASKS, ETC):

Offeror: _____________________________ RFQ No. 140P8625Q0014

PART III – PAST PERFORMANCE & RELEVANT EXPERIENCE

III.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A LIST OF JOBS FOR , PROVIDING HAZARDOUS WASTE

MANAGEMENT AND DISPOSAL SERVICES AS WELL AS EMERGENCY RESPONSE SERVICES

MAJOR PROJECT TASKS, ETC):

III.2 CONTRACT NUMBER: AMOUNT:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A LIST OF JOBS FOR , PROVIDING HAZARDOUS WASTE

MANAGEMENT AND DISPOSAL SERVICES AS WELL AS EMERGENCY RESPONSE SERVICES

MAJOR PROJECT TASKS, ETC):

Offeror: _____________________________ RFQ No. 140P8625Q0014

III.3 CONTRACT NUMBER: AMOUNT:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A LIST OF JOBS FOR , PROVIDING HAZARDOUS WASTE

MANAGEMENT AND DISPOSAL SERVICES AS WELL AS EMERGENCY RESPONSE SERVICES

MAJOR PROJECT TASKS, ETC):

III.4 LARGEST CONTRACT IN THE PAST THREE YEARS

CONTRACT NUMBER __________________________

CONTRACT AMOUNT __________________________

CONTRACT DATE __________________________

AGENCY/OWNER: __________________________

DESCRIPTION OF WORK:

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