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PAST PERFORMANCE QUESTIONAIRE

INSTRUCTIONS: Contractor must identify previous federal, state, local government and or private contracts completed that are similar in size and scope to the contract being evaluated. List at least three (3) contracts for evaluation. Contracts must be either competed or current within the last (5) years.

Past Performance Questionnaire

Contract Number Name Address, Zip Code

Telephone Number Email Address Type of Contract Contract Dollar Value Date of Award (if not completed provide status)

Type/Extent of Subcontracting

Percentage of Work completed by the Contractor

Description of Supply/Services provided, location & relevancy of work

Address, Telephone Number & Email of the Contact Person and Position

Contract Number

Type of Contract Contract Dollar Value Date of Award (if not

Contract Number

Type of Contract Contract Dollar Value Date of Award (if not

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