Atch_10_Contractor_Responsibility_Questionnaire.pdf

PDF 116 KB Posted

Attached to
Renovate Bldg. 663, JBSA-Randolph, TX Federal contract opportunity
Solicitation number
FA3016-16-R-0039
Issued by
Department of the Air Force Air Education and Training Command

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Atch 10 Contractor Responsibility Questionnaire

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FA3016-16-R-0039 Atch10

Contractor Responsibility Questionnaire

Contractor Name:

Contractor’s Address:

Point of Contact:

In the solicitation FA3016-16-R-0039 past performance will not be one of the evaluation factors, however, IAW FAR Part 9.1, the Contracting Officer shall determine whether prospective contractors are responsible. Therefore, please provide the following information:

UPROJECT # 1

1. Contract number:____________________________________________________

2. Project Title:________________________________________________________

3. Award date:_________________________________________________________

4. Scope of work:_______________________________________________________

5. Contract Value:______________________________________________________

6. Contracting Officer/Customer Contact Information:__________________________

UPROJECT # 2

1. Contract number:____________________________________________________

2. Project Title:________________________________________________________

3. Award date:_________________________________________________________

4. Scope of work:_______________________________________________________

5. Contract Value:______________________________________________________

6. Contracting Officer/Customer Contact Information:__________________________

FA3016-16-R-0039 Atch10

UPROJECT # 3

1. Contract number:____________________________________________________

2. Project Title:________________________________________________________

3. Award date:_________________________________________________________

4. Scope of work:_______________________________________________________

5. Contract Value:______________________________________________________

6. Contracting Officer/Customer Contact Information:__________________________

Sign and Date

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