Attachment_3_Experience_Reference_Sheet.doc

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Chemical Portable Latrines and Handwashing Station
Solicitation number
W912CN-19-Q-0016
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Attachment 3: Experience Reference Sheet

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ATTACHMENT 1

For W912CN-15-T-0167, Elevator Maintenance and Repair

WORK EXPERIENCE INFORMATION

NOTE: The offeror is responsible for reproducing copies of this form. Limit to references within the past three (3) years.

1. Name of Offeror/Bidder:

2. Name of Reference/Customer:_

Phone No.:

Fax No.

Email:

3. Contract Number:

4. Project Title:

5. Brief description of scope of work:

6. Period of Performance:_

7. Contract Amount:

Base Year:$ __________________
1st Option:$ __________________
2nd Option:$ __________________
3rd Option:$ __________________
Total:$ __________________

8. Offeror’s/Bidder’s statement on problems, if any, encountered during performance of work and any corrective actions taken to resolve problems. If no problems encountered, state NONE.

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