ATTACHMENT_4_-_Replacement_Page_225.pdf

U.S. Department of Homeland Security Washington, DC 20528

August 2010 Version

ATTACHMENT 4

PAST PERFORMANCE QUESTIONNAIRE

Solicitation: HSHQW9-13-R-00002

NAME OF CONTRACTOR REQUESTING THE REFERENCE: __________________

The purpose of this questionnaire is to obtain information regarding the quality of the above named Contractor’s past performance relative to a contract, completed or in progress, at your company/agency. The Federal Protective Service is considering this Contractor for Protective Security Officer services at various Federal buildings located in San Diego, CA. We would greatly appreciate your input regarding the quality of the Contractor’s past performance.

Handwritten responses are sufficient. It is requested that the individual(s) responsible for the administrative oversight of the project (e.g. security specialist, COR, COTR, etc.)

respond to this questionnaire. More than one copy of the questionnaire may be submitted if responses from more than one individual are appropriate.

Upon completion of the survey, please email to carlos.stewart@ice.dhs.gov and westccg@dhs.gov . If you have any questions, please call Carlos Stewart at (253)815- 4100. We appreciate your efforts on our behalf.

CONTRACT NO. OR PROJECT TITLE: _____________________________________

PERIOD OF PERFORMANCE TO

INCLUDE ALL OPTION PERIODS:_________________________________________

TOTAL PROJECT VALUE TO

INCLUDE ALL OPTION PERIODS: _________________________________________

ANNUAL NO. OF PROTECTIVE SECURITY OFFICER

HOURS:_________________________________________

Please provide a brief description of the scope of this project so that we determine any similarities to this contract:

HSHQW9-13-R-00002

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