Tab 16 SIR Attach 5 Experience Form.docx
DOCX document 21 KB Posted
- Solicitation number
- 6973GH-23-R-00166
About this file
This document contains a Past Experience Information Form template to be completed by contractors responding to Solicitation Number 6973GH-23-R-00166 from the Department of Transportation Federal Aviation Administration Franchise Acquisition Services. The solicitation is for the replacement of the Tactical Communications tower and existing shelter in Republic, Washington. The form requests information on the contractor's name, address, and past contract, task order, or purchase order numbers over $150,000 in the last three years including the dollar value, status as active or complete, completion date if applicable, project title and location, description of the contractor's role and responsibilities, and contact information for the project owner or manager.
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Text version
Announcement 6973GH-23-R-00166
PAST EXPERIENCE INFORMATION FORM
(To be completed by Contractor)
1. Contractor:
Name:
Address:
2. Contract /Task Order(TO) /Purchase Order (PO) Number:
3. Contract/TO/PO Dollar Value:
4. Contract/TO /PO Status: |_| Active |_| Complete
Completion Date (w/ extensions):
5. Project Title:
Location:
6. Project Description-- to include the role of the contractor on the project and specific responsibilities of the contractor in performance of the effort:
7. Project Owner or Project Manager for the Client – provide:
Name:
Address:
Telephone Number and E-mail:
Past Performance Experience Form
File details come from the government source that posted it. Updated .