USTDA_contractor_employee_form_V2.pdf

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DEFINITIONAL MISSION (DM): FOR COLOMBIA AND THE DOMINICAN REPUBLIC FOR SMART GRID AND RENEWABLE ENERGY PROJECT OPPORTUNITIES DM
Solicitation number
RFQ-CO201451144
Issued by

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Contrator Bio Sheet

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1 Name Last First Middle:

2 contractors Name:
3 Employees Address include ZIP code:
4 Contract Number:
s Position Under Contract:
6 Proposed Salary:
7 Duration of Assignment:
8 Telephone Number include area code:
9 Place of Birth:
10 Citizenship If nonUS citizen give visa status:
NAME AND LOCATION OF INSTITUTIONRow1:
MAJORRow1:
DEGREERow1:
DATERow1:
LANGUAGERow1:
Proficiency SpeakingRow1:
Proficiency ReadingRow1:
NAME AND LOCATION OF INSTITUTIONRow2:
MAJORRow2:
DEGREERow2:
DATERow2:
LANGUAGERow2:
Proficiency SpeakingRow2:
Proficiency ReadingRow2:
NAME AND LOCATION OF INSTITUTIONRow3:
MAJORRow3:
DEGREERow3:
DATERow3:
LANGUAGERow3:
Proficiency SpeakingRow3:
Proficiency ReadingRow3:
POSITION TITLERow1:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow1:
FromRow1:
ToRow1:
DollarsRow1:
POSITION TITLERow2:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow2:
FromRow2:
ToRow2:
DollarsRow2:
POSITION TITLERow3:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow3:
FromRow3:
ToRow3:
DollarsRow3:
SERVICES PERFORMEDRow1:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow1_2:
FromRow1_2:
ToRow1_2:
Days at RateRow1:
Daily Rate In DollarsRow1:
SERVICES PERFORMEDRow2:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow2_2:
FromRow2_2:
ToRow2_2:
Days at RateRow2:
Daily Rate In DollarsRow2:
SERVICES PERFORMEDRow3:
EMPLOYERS NAME AND ADDRESS POINT OF CONTACT TELEPHONERow3_2:
FromRow3_2:
ToRow3_2:
Days at RateRow3:
Daily Rate In DollarsRow3:

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