Attachment 1- Work Experience.docx

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Oil Water Separator/Wash Rack Sediment Catchment System Services
Solicitation number
W912CN-20-Q-0004
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W912CN-20-Q-0004

ATTACHMENT 1

WORK EXPERIENCE INFORMATION

OIL WATER SEPARATOR

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

1. Offeror/Vendor Name: ________________________________________________________

2. Name of Reference/Customer: _________________________________________________________

3. Phone No.: ________________________ Fax No.: _________________

Email: _______________________________________________

3. Contract Number: _____________________________________

4. Project Title: ________________________________________

5. Brief Description of Scope of Work: ____________________________________________________

6.Period of Performance:
Base Year:____________________________
1st Option:____________________________
2nd Option:____________________________
3rd Option:____________________________
4th Option:____________________________
7.Contract Amount:
Base Year:$ __________________
1st Option:$ __________________
2nd Option:$ __________________
3rd Option:$ __________________
4th Option:$ __________________

Total: $ __________________

Contract performed as:

[ ] Prime Contractor [ ] Joint Venture Partner [ ] Sub-Contractor [ ] Key Personnel

Contract performed as:

[ ] Firm-Fixed Price [ ] Fixed-Price Incentive [ ] Cost-Plus Award Fee [ ] Cost-Plus Incentive Fee [ ] Cost-Plus Fixed Fee

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