Past Performance and Experience Questionnaire.docx

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Attached to
Canine Diet for the Sevilleta NWR, NM Federal contract opportunity
Solicitation number
140F0221Q0024
Issued by
Department of the Interior Fish and Wildlife Service

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Solicitation # 140F0221Q0024

PAST EXPERIENCE & REFERENCES

REFERENCES

All quoters/bidders must complete this form 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 goods award. Past performance and experience may be a combination contracts similar in size and complexity to those stated in the Specifications similar in nature and complexity to the required goods. 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/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: ____________________________________________

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

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