B08_-_Attachment_3_-_PPQ.pdf

Attachment 3 P17PS01399 Page 1 of 2

Past Performance Page 1 of 2

Past Performance Questionnaire READ CAREFULLY: The purpose of this form is for the offeror to list construction projects performed during the past five (5) years that are similar to the work described in this solicitation and for those Government agencies or private sector companies identified in Volume I, Factor I, Subfactor 2

- Previous Experience. The number of projects listed shall not exceed ten (10) and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the competence criteria described in the Request for Proposal-Instructions for the Submission of Offers and Other Information. Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record.

NAME OF CONTRACTOR/OFFEROR:

# PROJECT

NAME:

Project Location:

Name of Owner:

Address of Owner:

Telephone Number:

Project Value:

Dates of Construction:

DESCRIPTION OF THE PROJECT AND SCOPE OF OFFEROR’S WORK

PERFORMANCE REMARKS

Attachment 3 P17PS01399 Page 2 of 2

Past Performance Page 2 of 2

DESCRIPTION OF THE PROJECT AND SCOPE OF OFFEROR’S WORK (continuation)

PERFORMANCE REMARKS (continuation)