NRC-30-08-539 Attachment No. 2 Qualifications Statement.doc

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Private Branch Exchange (PBX) Purchase Information Technology Infrastructure/Telecommunications
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NRC-30-08-539
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NRC-30-08-539 Attachment No. 2 Qualifications Statement

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RS-NRC-30-08-539

Attachment 2

QUALIFICATION STATEMENT

1. Firm Name & Address:

2. Year Firm Established:
3. Date Prepared:

4. Type of Firm:

__A. Small Business __B. Small Disadvantaged __C. Woman-Owned

__D. Other - ________________________

5. Principal Contacts: (List two by Name/Title/Telephone)

6. Present Offices: (Address/Telephone)

7. Corporate Work Experience, Last 3 Years

Note: List contracts similar in size(dollars) and scope.

Contract No:

Period of Performance:

Dollar Value:

Name of Gov./Commercial Entity:

Contracting Contact Name & Phone:

Technical Rep. Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

Contract No:

Period of Performance:

Contracting Contact Name & Phone:

Brief Description: (Describe the work and how it is similar to NRC(s Requirement.)

The foregoing is a statement of facts

Signature: ____________________________________________ Title: ______________________ Date: _______________

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