Atch_5_Contractor_Responsibility_Questionnaire.docx

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Repair 575 Depot Condensers @ Bldg 75
Solicitation number
FA301618R0049
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Atch 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:

FA301618R0049

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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