Attachment__5_-_Past_Contractual_Peformance.doc

ATTACHMENT 5

PAST CONTRACTUAL PERFORMANCE/EXPERIENCE

Offerors shall complete this form Past Contractual Performance/Experience and submit it with their proposal.

SECTION ONE: ABOUT YOUR COMPANY

PLEASE PREPARE AND DISTRIBUTE A PAST PERFORMANCE EVALUATION

ON MY COMPANY, AS LISTED BELOW:

YOUR COMPANY NAME

DUNS NUMBER

YOUR COMPANY STREET ADDRESS

CITY, STATE, ZIP

YOUR COMPANY PHONE NUMBER

YOUR COMPANY FAX NUMBER

YOUR PERSONAL/CONTACT NAME

YOUR TITLE

YOUR E-MAIL ADDRESS

If you don’t know your company’s DUNS number, go to: http://dnb.com/dnbhome.

SECTION TWO: PAST CONTRACTUAL PERFORMANCE REFERENCES

Please provide up to five, and no less than three, of your external customers to be surveyed that you have done business with in the past three years. External customers listed must be person(s) who have purchased services from your company. They must be customers you’ve sold services to, NOT vendors you’ve bought from.

ALL FIELDS ARE REQUIRED

1. CUSTOMER NAME:

NAME OF CONTACT:

PHONE:

E-MAIL ADDRESS:

2. CUSTOMER NAME:

NAME OF CONTACT:

PHONE:

E-MAIL ADDRESS:

3. CUSTOMER NAME:

NAME OF CONTACT:

PHONE:

E-MAIL ADDRESS:

4. CUSTOMER NAME:

NAME OF CONTACT:

PHONE:

E-MAIL ADDRESS:

5. CUSTOMER NAME:

NAME OF CONTACT:

PHONE:

E-MAIL ADDRESS:

REFERENCE: FEMA RFP - HSFE90-14-R-0001