Attachment_4,_Past_Experience_Quest.pdf

Attachment 4, Past Experience Questionnaire Solicitation FA5613-18-R-0017

For Official Use Only

PAST EXPERIENCE QUESTIONNAIRE

This Acquisition is for Maintenance and Repair of the Kitchen Fire Suppression Systems in the Kaiserslautern Military Community (KMC).

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Address:

Telephone Number: ____________________

Email Address: ____________________

Point of Contact: ____________________

Project Title or Brief Description of Work*:

Contract Number*: Contract Amount:

Contract Period or Dates of Performance*:

Contractor performed as the ☐ Prime Contractor ☐ Sub-Contractor

To be completed by the respondent and returned directly to the contracting office.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. SPECIFIC EXPERIENCE INFORMATION:

What Type of Fire Suppression Systems were maintained/installed:

Description of Services Performed: ________________________________________________________________

Number of Fire Suppression Systems maintained/installed: _____________________________________________