Atch_5_Contractor_Responsibility_Questionnaire.docx

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Renovate 2nd Floor of Hangar 70 & Upgrade HVAC System
Solicitation number
FA301617R0061
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Atach 5 Contractor Responsibility Questionnaire

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Contractor Responsibility Questionnaire

Contractor Name: Contractor’s Address: Point of Contact:

In the solicitation FA301617R0061 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:

FA301617R0061

Attachment 5

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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