Past_Experience_Reference_Form_0040609072.pdf

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Attached to
WI-GREEN BAY FISH RES OFC-MERCURY OUTBOA
Solicitation number
140FS223Q0073
Issued by

About this file

This document is a past experience reference form for solicitation number 140FS223Q0073 to provide services for the Department of the Interior Fish and Wildlife Service's Green Bay Fish Research Office for mercury removal. Quoters are required to complete this form to be considered, listing up to three past contracts of similar size, complexity, and duties to those required. References should include a name, phone number and email address. Experience details include contract type, number, value, agency, dates, and brief description of duties. Quoters must submit the completed form by the due date specified to the provided email address. This form may also be used to assess past performance.

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Text version

Attachment #2

RFQ# 140FS223Q0073

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: ______________________________________________________________________________

Month/Year work began Month/Year work ended: __________________________________________________

Brief description of duties:

Attachment #2

RFQ# 140FS223Q0073

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 No. 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: mack_washingtont@fws.gov.

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

mailto:mack_washingtont@fws.gov

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