Past_Performance.pdf

Solicitation No. 140P5225Q0009-Attachment 3, Past Experience

Experience and Past Performance READ CAREFlJLL Y: The purpose of this form is for the offeror to list projects performed during the past five (5) years that are similar to the work described in this solicitation. 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 work of this project as described in the specifications, plans, and site visit notes, and with the capability criteria described in the Request for Proposal. Include area codes with all telephone numbers. Type or print 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/QUOTER: ________________ _

PROJECT NAME:

Project Location:

Name of Owner:

Address of Owner:

Telephone Number:

Email Address:

Project Value:

Dates of Construction:

Project Cost/Price:

DESCRIPTION OF THE PROJECT AND SCOPE OF OFFEROR'S WORK

PERFORMANCE REMARKS

Key Personnel Qualifications READ CAREFlJLL Y: The purpose of this form is for the Offeror to list the qualifications of all key personnel as described in the solicitation.

Experience and qualifications include those developed on previous jobs; job-related training courses;

certificates and licenses; honors; and specialty skills that are relevant to the proposed project. Provide dates, but do not send documents.

Provide the state in which registration or license is held and the registration or license number. Fill in the information by typing or printing legibly.

NAME OF CONTRACTOR/QUOTER: __________________ _

PERSONNEL INFORMATION:

Name:

Job Title:

Years of Experience With This Firm: Years of Experience With Other Firms:

EDUCATION AND PROFESSIONAL REGISTRATION:

Top Educational Level Obtained: Year:

Area of Specialization:

Professional Registrations:

EXPERIENCE AND QUALIFICATIONS

List of proposed subcontractors The purpose of this form is for the Offeror to list the proposed subcontractors who will perform on the contract. Include a brief description of the work they will perform. Fill in the information by typing or printing legibly.

NAME OF CONTRACTOR/QUOTER: _________________ _

SUBCONTRACTOR NAME:

UEI: Small business? yes; no.

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

UEI: Small business? yes; no.

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

UEI: Small business? yes; no.

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

UEI: Small business? yes; no.

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

Subcontractor Reference

READ CAREFULLY: The purpose of this form is for the offeror to provide references for key subcontractors identified in the Instructions, Conditions, and Notices to Offerors who are considered critical to the successful accomplishment of the project. Use as many sheets as necessary. These subcontractor references should include additional relevant projects similar to the work described in the plans and specifications. Include area codes with all telephone numbers. Fill in the information by typing or printing legibly.

SUBCONTRACTOR (PROPOSED): _________________ _

ADDRESS:

TELEPHONE NUMBER:

PROJECT NAME:

Name of Owner:

Location:

Prime Contractor Telephone Number:

Email Address:

Subcontract$ Value:

Dates of Service:

Reference Name and Telephone Number.

DESCRIPTION & SCOPE OF WORK

SPECIFIC AREAS OF EXPERIENCE (SEE INSTRUCTIONS FOR THE SUBMISSION OF

QUOTES AND OTHER INFORMATION -CAPABILITY CRITERIA):

General References

READ CAREFULLY: The purpose of this form is for the quoter to provide the Government with general references in the spaces provided as described in Attachment 1, Combined Synopsis/Solicitation. Fill in the information by typing or printing legibly.

It is especially important that the quoter disclose instances in which their relationships with the references may be considered less than fully satisfactory. The quoter 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 a quoter has been less than candid with the Government, which could result in an unfavorable assessment of the quoter's past performance record. Provide explanations on separate sheets as necessary.

NAME OF CONTRACTOR/OFFEROR: