B08_Past_Performance_Questionnaire.doc

DOC document 27 KB Posted

Attached to
BR-43 REPAIR Federal contract opportunity
Solicitation number
140L3623Q0043
Issued by
Department of the Interior Bureau of Land Management

About this file

This document contains a past performance questionnaire for contractors to complete and submit with their quote in response to solicitation number 140L3623Q0043. The questionnaire requests information on the contractor's experience, including the number of years of relevant experience for both the contractor and company. It also asks for details on completed projects within the last three years that are relevant to the solicitation's requirements, including contract numbers, amounts, dates completed, and references. Additional questions cover concurrent contract commitments, failure to complete past work, and work completed by performance bond. The contractor must certify that all statements are complete and correct to the best of their knowledge.

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A06_Specifications.pdf PDF
Sol_140L3623Q0043.pdf PDF
A06_Schedule_of_Items.pdf PDF
B03_Wage_Determination.pdf PDF
A06_Drawings.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 .