Form_1-_Experience_and_Past_Performance_-_Attachment_No.06.pdf

Offeror: _____________________________ RFQ No. P15PS01200 Attachment No. 06

FORM 1

EXPERIENCE AND PAST PERFORMANCE

Use this form to demonstrate your successful past experience of relevant jobs that compare favorably to the work offered in this project. Refer to the instructions in Section L, Instructions for the Submission of Offers and Other Information, and Section M, Evaluation Factors. List contracts and other pertinent work to describe how your experience is relevant to the requirements of this RFQ. Use as many copies of this Form, or an equivalent, as may be required. Attach additional documents as needed. If you have no relevant experience, you must state that on this form in order to qualify for a neutral rating.

PART I – FINANCIAL DATA

I.1 FINANCIAL DATA AS OF ________________ (date)

CURRENT ASSETS $_________________ Name of Bank: _________________

CURRENT LIABILITIES $_________________ Point of Contact: _________________

NET WORTH $_________________ Phone Number: _________________

PART II – EXISTING COMMITMENTS

II.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A BRIEF NARRATIVE INCL UDING MAJOR PROJ ECT TASKS)

PERFORMANCE PERIOD:

Offeror: _____________________________ RFQ No. P15PS01200

II.2 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A BRIEF NARRATIVE INCL UDING MAJOR PROJECT TASKS)

PERFORMANCE PERIOD:

Offeror: _____________________________ RFQ No. P15PS01200

PART III – PAST PERFORMANCE & RELEVANT EXPERIENCE

III.1 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A BRIEF NARRATIVE INCL UDING MAJOR PROJECT TASKS)

III.2 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A BRIEF NARRATIVE INCL UDING MAJOR PROJECT TASKS)

Offeror: _____________________________ RFQ No. P15PS01200

III.3 CONTRACT NUMBER: AMOUNT:

AGENCY/OWNER:

CONTACT PERSON: PHONE NUMBER:

DESCRIPTION OF WORK (PROVIDE A BRIEF NARRATIVE INCL UDING MAJOR PROJECT TASKS)

III.4 LARGEST CONTRACT IN THE PAST THREE YEARS

CONTRACT NUMBER __________________________

CONTRACT AMOUNT __________________________

CONTRACT DATE __________________________

AGENCY/OWNER: __________________________

DESCRIPTION OF WORK: