P2-Experience PastPerformanceQuestion.pdf

Experience and Past Performance Questionnaire

Solicitation Number and Project Location: _________________________________________________________

Business Name: ______________________________________Contact Name: __________________________

Phone Number: ______________________ Email: _________________________________________________

How many years of relevant experience have you or your business had regarding the type of work required by this solicitation? ____________

How many years experience in contracting have you or your business had as a Prime Contractor? ____________ …. as a Sub-contractor? ____________

Experience: List the projects your business has completed that are equivalent and/or relevant in both magnitude and complexity to the requirements of this solicitation. Include: [] the contract amount [] a brief description of the work performed [] date completed, and [] the name of the contact with telephone number and email address. Attach a separate page if necessary.

Past Performance: List a minimum three references with contact information (name, phone number, email)

Have you ever failed to complete any work awarded to you? ______Yes _____No

Has work ever been completed by performance bond? ______Yes ______No

If “Yes” to either item, specify location and reason on a separate page.

CERTIFICATION

I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Bureau of Land Management with any information needed to verify my capability to perform this project.

Certifying Official Name and Title: ________________________________________________________________

Signature (Sign in Ink): _________________________________________________________________________

Date: _______________________________________________________________________________________