Past_Experience_Questionnaire.pdf
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- NC-EDENTON NFH-CARPETING
- Solicitation number
- 140F0421Q0114
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Text version
PAST EXPERIENCE QUESTIONNAIRE
(Offerors must complete this form for evaluation purposes)
NAME OF FIRM POINT OF CONTACT
TELEPHONE NO.
EMAIL ADDRESS OR FAX
NO.
PRIOR PROJECT EXPERIENCE
(TO BE COMPLETED BY THE OFFEROR - LIST UP TO FIVE (5) INDIVIDUAL PROJECTS)
PROJECT DESCRIPTION
(USE BLANK PAGE IF NECESSARY)
CONTRACT/PROJECT
NO.
LOCATION
CONTRACT AMOUNT (ROUND
TO NEAREST DOLLAR)
ORIGINAL FINAL
1.
2.
3.
4.
5.
NAME OF OWNER/AGENCY POINT OF CONTACT TELEPHONE NO. FACSIMILE NO.
1.
2.
3.
4.
5.
ORIGINAL PROJECT DATES
WERE YOU A PRIME CONTRACTOR
OR SUBCONTRACTOR?
WERE THERE
CONTRACT
MODIFICATIONS?
(YES/NO)
HOW MANY?
WHO INITIATED
THEM? CLIENT OR
CONTRACTOR? START COMPLETION
1.
2.
3.
4.
5.
WERE THERE ANY
TIME EXTENSIONS?
(YES/NO)
IF SO, INDICATE
TOTAL EXTENDED
DAYS?
WAS THE
SCHEDULE MET?
(YES/NO)
IF NOT, WHAT WAS THE REASON?
(USE BLANK PAGE IF NECESSARY)
1.
2.
3.
4.
5.
HAVE YOU EVER
ENTERED A
DISPUTE? (YES/NO)
IF SO, WHAT WAS THE REASON?
(USE BLANK PAGE IF NECESSARY)
HAVE YOU EVER
BEEN DEFAULTED?
(YES/NO)
IF SO, WHAT WAS THE REASON?
(USE BLANK PAGE IF NECESSARY)
1.
2.
3.
4.
5.
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