Attachment 4_Technical Form.pdf

ATTACHMENT 4 – TECHNICAL / PAST PERFORMANCE FORM

Quoter’s Name: _____________________________________________________________________

Address: ___________________________________________________________________________

Quoter Point of Contact (POC) Name: ___________________________________________________

Quoter Telephone Number:_____________________________________________________________

Quoter Email:___________________________________________________________________________

1. Quoter has previously provided portable sanitation rentals for large events (concerts, air shows, sporting events, military training, or the like). YES NO

2. Quoter has performed portable sanitation services for rentals on regular and recurring frequencies. YES NO

3. Quoter will provide on-site quality control for each call/order? YES NO

*Please provide relevant information on subsequent pages

If Subcontracting. . .

1. Quoter affirms they will perform at least 51% of the work ordered through this BPA.

YES NO N/A

2. Will on-site quality assurance be provided by the prime? YES NO N/A

3. Please describe the functions to be retained by the prime:_______________________________

Quoter Name .

Service: ________________________________________________________________________ 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:___________________________________________________________________

Did the service involve providing portable sanitation rentals for large events (concerts, air shows, sporting events, military training, or the like)? YES NO

Did the service involve performing portable sanitation services for rentals on regular and recurring frequencies? YES NO

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________ Address: ____________________________________________________________________________ Telephone Number: ___________________________________________________________________ Email:_______________________________________________________________________________

Service: ________________________________________________________________________ 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:___________________________________________________________________

Did the service involve providing portable sanitation rentals for large events (concerts, air shows, sporting events, military training, or the like)? YES NO

Did the service involve performing portable sanitation services for rentals on regular and recurring frequencies?

YES NO

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________ Address: ____________________________________________________________________________ Telephone Number: ___________________________________________________________________ Email:_______________________________________________________________________________

Quoter Name .

Service: ________________________________________________________________________ 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:___________________________________________________________________

Did the service involve providing portable sanitation rentals for large events (concerts, air shows, sporting events, military training, or the like)? YES NO

Did the service involve performing portable sanitation services for rentals on regular and recurring frequencies?

YES NO

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________ Address: ____________________________________________________________________________ Telephone Number: ___________________________________________________________________ Email:_______________________________________________________________________________

Service: ________________________________________________________________________ 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:___________________________________________________________________

Did the service involve providing portable sanitation rentals for large events (concerts, air shows, sporting events, military training, or the like)? YES NO

Did the service involve performing portable sanitation services for rentals on regular and recurring frequencies?

YES NO

Contract Point of Contact to Verify Above Service

Point of Contact: _____________________________________________________________________ Address: ____________________________________________________________________________ Telephone Number: ___________________________________________________________________ Email:_______________________________________________________________________________