J-1-2,_Past_Performance_and_References.xlsx
XLSX spreadsheet 11 KB Posted
- Attached to
- Operational Rooms, Colombia Federal contract opportunity
- Solicitation number
- SAQMMA17R0127
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Attach. J-1-2
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Past Performance Questionnaire
| PAST PERFORMANCE & REFERENCES | |||||
| Indicate the past performance information of the firm in similar projects performed in the last five (5) years. Include maximum 10 projects. Do not include certifications or contract copies. In the case we needed we will require it afterwards. | |||||
| One | Two | Three | Four | Five | |
| NAME OF THE CLIENT (CONTRACTING PARTY) | |||||
| CLIENT ADDRESS | |||||
| CLIENT TELEPHONE NUMBER | |||||
| CLIENT POINT OF CONTACT (Name & Title) | |||||
| POINT OF CONTACT EMAIL ADDRESS |
| CONTRACT NUMBER |
| TYPE OF CONTRACT( * 1) |
| NAME OF THE CONTRACT OR PROJECT |
| PROJECT LOCATION |
| PROJECT STARTING DATE |
| PROJECT FINISH DATE |
| WAS THE PROJECT FINISHED ON TIME ( Explain if needed) |
| SQUARE METERS OR UNITS (Indicate unit measurements) |
| CONTRACT COST IN PESOS |
| CONTRACT COST IN MONTHLY MINIMUM SALARIES |
| INDICATE IF IN THIS PROJECT YOU WERE THE PRIME CONTRACTOR , SUBCONTRACTOR OR ASSOCIATE |
| INDICATE THE PERCENTAGE OF PARTICIPATION OF YOUR FIRM IN THIS PROJECT |
| BRIEF DESCRIPTION OF ACTIVITIES BEING PERFORMED |
| COMPARISON OF THE WORK PERFORMED WITH THIS SOLICITATION ( *2 ) |
| BRIEF DESCRIPTION OF TECHNICAL PROBLEMS ENCOUNTERED AND THE WAY THEY WERE SOLVED |
| METHOD OF ACQUISITION (Public solicitation, private or non competed) award criteria |
| COST/PRICE MANAGEMENT HISTORY (any cost overruns and under runs, and cost growth and changes) |
| HAVE YOU HAD ANY CONTRACT TERMINATIONS IN THE LAST TEN (10) YEARS? |
| REASONS FOR TERMINATIONS (for contractor convenience ó for default or other) |
| (*1)Consulting, construction, design, work oversight, delegated administration If you are not a company explain if you were the |
superintendent, director or other.
| (*2) Here you should indicate which activities performed are similar to the work being contracted. |
| I certify that the information is accurate and verifiable |
Signature of the Legal Representative and Date Date
Name (Print) ID Number
Past Performance Questionnaire Attachment J-1-1
Artículo 289 del Código Penal Colombiano: “El que falsifique documento privado que pueda servir de prueba, incurrirá, si lo usa, en prisión de uno (1) a seis (6) años .”
File details come from the government source that posted it. Updated .