Section_J_-_Att_No__006_Experience_and_PP_Form.pdf
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- Attached to
- PORTABLE AND VAULT TOILETS SERVICES AND RENTALS
- Solicitation number
- 140P8621Q0060
About this file
This document contains an experience and past performance form for contractors to submit with proposals for solicitation number 140P8621Q0060 from the Department of the Interior National Park Service Pacific West Region. The form requests information on contractors' financial data including current assets and liabilities, existing commitments on previous contracts including contract numbers, amounts, agencies, contacts and descriptions of work, as well as past performance and relevant experience through similar contract details. Contractors must provide details of at least three but no more than four examples of relevant past work to qualify for evaluation. The solicitation is for portable and vault toilet services and rentals to support National Park facilities in the Pacific West Region.
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Text version
EXPERIENCE AND PAST PERFORMANCE
FORM
Use this form to demonstrate your successful past experience of relevant jobs that compare favorably to the work offered in this project. Refer to the RFQ Section L – Instructions, Conditions, and Notices to Offerors. List contracts and other pertinent work to describe how your experience is relevant to the requirements of this RFQ.
Use as many copies of this Form, or an equivalent, as may be required. Attach additional documents as needed. If you have no relevant experience, you must state that on this form in order to qualify for a neutral rating.
PART I – FINANCIAL DATA
I.1 FINANCIAL DATA AS OF ________________ (date)
CURRENT ASSETS $_________________ Name of Bank: _________________
CURRENT LIABILITIES $_________________ Point of Contact: _________________
NET WORTH $_________________ Phone Number: _________________
PART II – EXISTING COMMITMENTS
II.1 CONTRACT NUMBER: AMOUNT:
AGENCY/OWNER:
CONTACT PERSON: PHONE NUMBER:
DESCRIPTION OF WORK:
PERFORMANCE PERIOD:
II.2 CONTRACT NUMBER: AMOUNT:
AGENCY/OWNER:
CONTACT PERSON: PHONE NUMBER:
DESCRIPTION OF WORK:
PERFORMANCE PERIOD:
RFQ No. 140P8621Q0060 Attachment No. 006
PART III – PAST PERFORMANCE & RELEVANT EXPERIENCE
III.1 CONTRACT NUMBER: AMOUNT:
AGENCY/OWNER:
CONTACT PERSON: PHONE NUMBER:
SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:
III.2 CONTRACT NUMBER: AMOUNT:
AGENCY/OWNER:
CONTACT PERSON: PHONE NUMBER:
SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:
III.3 CONTRACT NUMBER: AMOUNT:
AGENCY/OWNER:
CONTACT PERSON: PHONE NUMBER:
SPECIFIC AREAS OF EXPERIENCE WHICH RELATE TO THE WORK OF THIS PROJECT:
III.4 LARGEST CONTRACT IN THE PAST THREE YEARS
CONTRACT NUMBER __________________________
CONTRACT AMOUNT __________________________
CONTRACT DATE __________________________
AGENCY/OWNER: __________________________
DESCRIPTION OF WORK:
RFQ No. 140P8621Q0060 Attachment No. 006
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