B08_-_Past_Experience_and_References_Form.doc

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Attached to
TX-SANTA ANA NWR-FIRE-BIL FUEL BREAKS
Solicitation number
140FS223Q0065
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This document is a past experience and references form required to be completed by all bidders for solicitation number 140FS223Q0065 from the Department of the Interior Fish and Wildlife Service. Bidders must provide details of up to three relevant past contracts including contract type, number, value, agency, point of contact, dates and brief description of duties performed. References should include a name, phone number and valid email address. The solicitation is for fuel break construction services at the TX-SANTA ANA NWR. Completed forms are due by the date and time specified to Darla Freyholtz Ballard at the provided email address for consideration.

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140FS223Q0065

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 Darla Freyholtz Ballard email: darla_freyholtzballard@fws.gov

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