B08_Past_Performance_Questionnaire.docx

DOCX document 29 KB Posted

Attached to
LEO VEHICLE UPFITTING
Solicitation number
140L3626Q0051
Issued by

About this file

This is a Past Performance Questionnaire that must be completed and submitted with quotes for the Bureau of Land Management's LEO Vehicle Upfitting solicitation (140L3626Q0051). The questionnaire requires contractors to provide company information including business type, SAM Entity Number (UEI), address, and contact details.

Contractors must document relevant experience by specifying years of experience with work types requested in the solicitation, years of experience as prime and subcontractors, and detailed information on projects completed within the last three years, including contract numbers, amounts, project types, completion dates, and reference contacts. Projects listed must demonstrate relevance to the solicitation's requirements in terms of duties performed and technical complexity; irrelevant projects will not be considered. The form also requires contractors to list all concurrent contract commitments with names, addresses, telephone numbers, and start/finish dates, and to disclose any history of incomplete work or performance bonds. A certifying official must sign the questionnaire in ink, certifying that all statements are complete and correct and that named references are authorized to verify the contractor's capability to perform the project.

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Sol_140L3626Q0051.pdf PDF
A04_SOW.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 .