B08_Past_Performance_Questionnaire.doc

DOC document 27 KB Posted

Attached to
GARFIELD/TREASURE NOXIOUS WEED TREATMENT Federal contract opportunity
Solicitation number
140L3624Q0021
Issued by
Department of the Interior Bureau of Land Management Montana-Dakotas

About this file

This document contains a past performance questionnaire to be submitted with quotes for a federal contract opportunity. The past performance questionnaire requests information on the contractor's relevant experience, including the number of years of experience the contractor and company have in the types of work requested by the solicitation. It also asks the contractor to list completed projects from the last three years that are relevant to the solicitation's requirements in terms of duties performed and technical complexity, providing contract numbers, amounts, dates completed, and references. Additionally, the questionnaire asks the contractor to disclose any concurrent contract commitments that would run at the same time as the work in this solicitation, and to disclose any past failures to complete work or projects requiring performance bonds. The certification section requires the contractor to attest that all statements are complete and correct.

The related federal contract opportunity is solicitation number 140L3624Q0021 for noxious weed treatment services in Garfield and Treasure Counties, Montana, issued by the Bureau of Land Management Montana-Dakotas.

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A04_Project_2_Howery_Island_Map.pdf PDF
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A04_Project_1_Devils_Creek_Map.pdf PDF
B03_Wage_Determination.pdf PDF

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Text version

Past Performance Questionnaire

(THIS MUST BE COMPLETED AND SUBMITTED WITH YOUR QUOTE)

Contractor Name:______________________________________________________________________ Address:__________________________________ City:_______________ State: _____ Zip:________ Phone Number: ____________________ SAM Entity Number (UEI): ____________________________ Type of Business:

_____Company ____Co-partnership ______Corp._____ Individual ____Non-Profit Org.

1. How many years of RELEVENT experience do you have and/or your company have regarding the types of work requested by this solicitation?

-You__________________ -Your Company__________________

2. How many years of experience in contracting does your company have as a Prime Contractor and/or a Sub-Contractor:

-Prime_________________ -Sub-Contractor__________________

3. List below projects your business has completed within the last three years. Include the contract number and amount; the type of project; the date completed and a reference contact name and telephone number for each project.

Note: Past Projects must be relevant to the requirements of this solicitation in terms of duties performed, and the technical/complexity aspects of the duties required. Projects listed that are not relevant to this solicitation and its requirements will not be considered. (attach separate page if additional room is needed)

4. List all contract commitments you have that will run concurrently with the work requested in this solicitation. Include name, address, telephone number, start and finish date.

5. Have you ever failed to complete any work awarded to you? ______Yes _____No

6. Has work ever been completed by performance bond? ______Yes ______No

If “Yes” to either item, specify location and reason:

CERTIFICATION

I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Bureau of Land Management with any information needed to verify my capability to perform this project.

Certifying Official Name and Title :

Authorized Signature (Sign in Ink):

Date:

File details come from the government source that posted it. Updated .