Past_Performance_Form.doc

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Trash Collection and Janitorial Services, Vieques
Solicitation number
140F0422Q0012
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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. 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. Information may be submitted in another format (word or pdf file) as long as all of the information is included.

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: ____________________________________________

PAGE

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