2d - Attachment A - PAST PERFORMANCE REFERENCE - GS05P11SVD0042.pdf

Repair, Alteration and Construction IDIQ GS05P11SVD0042 Various Locations State of Michigan

PAST PERFORMANCE REFERENCE

ATTACHMENT A

Note: In accordance with the instructions contained in the paragraph entitled Past Performance of Offeror, the offeror shall complete this form and submit as part of their proposal. Make additional copies as necessary and complete one form for each reference. Please number each sheet (e.g. 1 of 3, 2 of 3) based on the number of references that you are submitting (minimum of 3, no more than 5).

1. OFFEROR (COMPANY NAME) 2. REFERENCE NO. OF

3. CONTRACT STATUS AND TYPE

CURRENT GOVERNMENT

PREVIOUS NON-GOVERNMENT

4. PROJECT NAME AND LOCATION (BUILDING, CITY, STATE)

5. CONTRACT NUMBER (IF FEDERAL GOVERNMENT CONTRACT) 6. CUSTOMER (COMPANY NAME OR GOVERNMENT AGENCY)

7. CONTACT PERSON (NAME AND TITLE) 8. CONTACT PHONE NUMBER

9. TYPE OF FACILITY (office building, courthouse, hospital, school, etc.) 10. SIZE OF PROJECT (SQUARE FOOTAGE)

11. IS THE PROJECT FOR OR SIMILAR TO REPAIR AND CONSTRUCTION DEMONSTRATING MUL-

TIPLE DISCIPLINES OF WORK?

YES NO

12. IF COMPLETED PROJECT – COMPLETED ON TIME?

YES NO (If No, explain on back) 12A. START DATE 12B. COMPLETION DATE (not more than 5 years from solicitation close date)

12C. NUMBER OF DAYS

13A. IF CURRENT PROJECT – ON SCHEDULE?

YES NO (If No, explain on back)

13B. START DATE 13C. ESTIMATED COMPLETION DATE 13D. PERCENT COMPLETED

(No less than 90%)

14. DESCRIPTION OF PROJECT AND COMPLEXITY

15. LIST WHICH ELEMENTS OF THE PROJECT WERE SUBCONTRACTED

16. PROBLEMS ENCOUNTERED AND CORRECTIVE ACTIONS TAKEN