B08_-_Past_Experience_and_References_Form.doc

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OK-WICHITA MTNS WILDL RFG-HGR FUELS BREAK
Solicitation number
140FS223Q0138
Issued by

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This document is a past experience and references form required for solicitation number 140FS223Q0138 from the Department of the Interior Fish and Wildlife Service. Vendors must complete this form listing up to three past contracts similar in size, complexity, and duties to the required wildland fuels break services near the Wichita Mountains Wildlife Refuge in Oklahoma. For each past experience, vendors must provide the contract type and number, total value, agency, point of contact, dates of work, and brief description of duties. References should include a name, phone number, and valid email address. The completed form is due by the date and time specified in the solicitation and must be emailed to the address provided.

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140FS223Q0138

PAST EXPERIENCE & REFERENCES

REFERENCES:

This form must be completed by all quoters/bidders in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience that is pertinent to this position. Past performance and experience may be a combination of up to three contracts similar in size and complexity to those stated in the Scope of Work and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training that would enable you to better perform the work outlined in the specifications. Reference information should include a point-of-contact's name, telephone number and e-mail address.

Experience No. 1

Contract/Work type: ____________________________________________

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

Valid E-mail address: ____________________________________________

Month/Year work began: Month/Year work ended: ________________________________________

Brief description of duties:

Experience No. 2

Contract/Work type: ____________________________________________

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

Valid E-mail address: ____________________________________________

Experience No. 3

Contract/Work type: ____________________________________________

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

Valid E-mail address: ____________________________________________

Submit NLT than the due date and time specified within this solicitation to Terri Ferguson email: terri_ferguson@fws.gov

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