B08_Past_Performance_Questionnaire.doc

DOC document 27 KB Posted

Attached to
KNIGHT PIPELINE EXTENSION Federal contract opportunity
Solicitation number
140L3624Q0042
Issued by
Department of the Interior Bureau of Land Management Montana-Dakotas

About this file

This document is a Past Performance Questionnaire that must be completed and submitted with the quote for the federal contract opportunity named "KNIGHT PIPELINE EXTENSION" (Solicitation Number 140L3624Q0042). The Questionnaire requests information about the contractor's relevant experience, years of experience as a Prime Contractor and/or Subcontractor, details on past projects completed within the last 5 years, current contract commitments, and whether the contractor has ever failed to complete any awarded work or had work completed by a performance bond. The contractor must certify that the information provided is complete and accurate. The contract opportunity is being solicited by the Department of the Interior Bureau of Land Management Montana-Dakotas.

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B11_Question_and_Answer_Document_0002.pdf PDF
A06_Revised_Specifications_0001.pdf PDF
Sol_140L3624Q0042_Amd_0001.pdf PDF
A06_Revised_SOI_0001.pdf PDF
A06_Drawings-Maps.pdf PDF
A06_Specifications.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 five 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 .