Contractors Experience Form.docx

CONTRACTOR EXPERIENCE FORM

SOLICITATION NUMBER: __________________________________

PROJECT TITLE: __ _______________________________

PLEASE COMPLETE ALL REQUESTED INFORMATION

Name: _________________________________ Company name: _ ______________________________ Street Address: ____________________________________ City: ____________________ State: _ ____ Zip: ___ Phone number: ____________________________ DUNS: _________________ CAGE Code: ________ Will you be performing this Work?

__ __ Yes (list experience) _____ Yes, with help of Subcontractor (Please list experience of your firm and Subcontractor) Employee / Subcontractor’s Name: ___________________________________________ ** FAR 52.219-14 requires that at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern.

Number of Employees who will be working on this contract:

Full Time: ___________ Part Time: ___________ Seasonal: ___________ Do you and your Subcontractor have Commercial Cleaning Experience?

________ Yes Years: ____________ Months: __________ _________ No ____ ____ N/A

EXPERIENCE #1

Self or Subcontractor? __ ____________________________________ Job Title: ____________________________ Date work performed: ______________________ Reference name: __ ________________________ Reference Telephone Number: _______________________ Additional Information:

EXPERIENCE #2

Self or Subcontractor? ___________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________

EXPERIENCE #3

Self or Subcontractor? ___________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________