Past Experience Ref Form.doc

DOC document 30 KB Posted

Attached to
Stone Material-Don Edwards San Francisco Bay NWR Federal contract opportunity
Solicitation number
140F0220Q0033
Issued by
Department of the Interior Fish and Wildlife Service Region 2

About this file

This document contains a past experience reference form for solicitation number 140F00220Q0025/01. Quoters are required to complete this form to be considered, listing up to three relevant past contracts similar in size, complexity, and duties to those described in the solicitation's scope of work. For each, they must provide the contract type, number, value, agency, point of contact, dates, and brief description of duties performed. References should include a name, phone number, and email address. The form is to be submitted by the due date and time specified in the solicitation to the email address provided.

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Other files attached to Stone Material-Don Edwards San Francisco Bay NWR, newest first.
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Sol_140F0220Q0033_Amd_0001.pdf PDF
Sol_140F0220Q0033_amend 0001_0001.docx DOCX document
ATTACHMENT_1_Access Exhibits.pdf PDF
Sol_140F0220Q0033.pdf PDF
ATTACHMENT_2_Master_QAPP_2018_Final.pdf PDF
52.212-3 Oferror Representations and Certifications.docx DOCX document
PAST PERFORMANCE SURVEY FORM.doc DOC document

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Text version

(Attachment #4) - Solicitation # 140F00220Q0025/01

PAST EXPERIENCE & REFERENCES

REFERENCES

This form must be completed by all quoters/bidders in order to receive consideration. If additional space is needed, this form may be duplicated as necessary. List any current or past experience that is pertinent to this position. Past performance and experience may be a combination of up to three contracts similar in size and complexity to those stated in the Scope of Work and work experience in similar positions, performing duties similar in nature and complexity to the required services. Include (separately) details of any training that would enable you to better perform the work outlined in the specifications. Reference information should include a point-of-contact's name, telephone number and e-mail address.

Experience No. 1

Contract/Work type: ____________________________________________

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

E-mail address: ____________________________________________

Month/Year work began: Month/Year work ended: ________________________________________

Brief description of duties:

Experience No. 2

Contract/Work type: ____________________________________________

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

E-mail address: ____________________________________________

Experience No. 3

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

E-mail address: ____________________________________________

Experience 4

Contract Number (if applicable): ____________________________________________

Total Contract Value: __________________________________________

Agency/firm for who work was performed: ____________________________________________

Contact person at the site: Telephone #: ____________________________________________

E-mail address: ____________________________________________

Submit NLT than the due date and time specified within this solicitation to: E-mail: joni_dutcher@fws.gov.

*NOTE: This form may also be used to assess Past Performance.

Solicitation # 140F0418Q _____/01

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