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HSBP1013R0099 ATTACHMENT 4B:
Past Performance Relevant Experience Form
Company Name: ____________________________________
Referenced Contract: ____________________________________
Instructions: Offerors will complete the following worksheet for each contract provided as a reference.
| ITEM |
| DESCRIPTION |
| YES/NO |
| QUANTITY |
| 1 |
| Did you serve as the prime contractor (rather than a subcontractor) for the referenced effort? |
| 2 |
| What were the total contract dollar value and the term of the contract, including all option periods? |
_____years
| 3 |
| Did you develop integrated preventive maintenance plans and schedules for facilities equipment preventive maintenance? What was the approximate square footage of this facility location? How many units of equipment did it contain? |
Sq ft_______
Units ______
| 4 |
| Did the contract call for remedial maintenance, repairs and alterations? |
| 5 |
| Did you provide on call emergency repair services that were available 24 hours/days and 7 days per week? |
| 6 |
| Did you evaluate and make recommendations for improving your client’s maintenance procedures? |
| 7 |
| Did you conduct maintenance services that are subject to Agency and Federal programs and standards? |
| 8 |
| Was the client a Federal/ State/ municipal law enforcement facility? How many of these types of clients did you have? |
| 9 |
| Did you develop program performance baselines and controls? |
| 10 |
| Did you perform interior and routine maintenance on large HVAC (e.g. filters, vacuuming)? Indicate manufacturer/models. (use separate sheet if required.) |
Use separate sheet if required.
| 11 |
| Did you utilize environmentally friendly (green) cleaning materials and follow federal/state/local disposal procedures? |
| 12 |
| Did you team with a diverse group of subcontractors that performed a variety of services? How many subcontractors were in place at one time? |
# of Subcontractors _________
| 13 |
| Did you evaluate and make recommendations for improving your client’s (preventive) maintenance web-based tracking data system(s)? |
| 14 |
| Did you use web-based tracking system to monitor maintenance progress? Which system did you use? |
| 15 |
| Did you develop and manage the client’s repairs and alterations and operation and maintenance schedules? If so, how many of such maintenance schedules did you manage? How many years for referenced project? |
Years ______
| 16 |
| Did you provide validation of equipment inventory? |
| 17 |
| Have you ensured that data from either equipment validation or other similar projects is adequately transferred to client? |
| 18 |
| Did you maintain on-site or off-site parts and supplies inventories? Please specify. How large of an inventory budget, annually? |
annually
| 19 |
| Did you develop and operate under a comprehensive quality assurance surveillance plan? |
| 20 |
| Did the contract contain performance-based measures and service-level agreements? |