Attachment 2 Technical Evaluation.pdf

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USAFA LPG
Solicitation number
FA700020R0019
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ATTACHMENT 1 - TECHNICAL FORM

Quoter’s Name: ________________________________________________________________________

Address: _________________________________________________________________________________

Quoter Point of Contact (POC) Name: ______________________________________________________

Quoter Telephone Number: _______________________________________________________________

Quoter Email:___________________________________________________________________________

Customer: ____________________________________________________________________

This service was performed by the named quoter as a (Circle one): Prime Contractor or Subcontractor

Place of Performance: _________________________________________________________________

Contract Number:______________________________________________________

Contract Value: ______________________________________________________________________

Contract Period or Dates of Performance: _________________________________________________

Service Description:___________________________________________________________________

How many gallons of gas have you delivered? _______

What are the sizes of the tanks you re-fill? _______

Have any tanks require maintenance? (Circle one) Yes / No. If yes, what type of maintenance was required?

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________

Address: ____________________________________________________________________________

Telephone Number: ___________________________________________________________________

Email:_______________________________________________________________________________

*** Up to 3 Technical Forms will be accepted ****

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