Contractor's_Experience_Form.docx

DOCX document 12 KB Posted

Attached to
Lake Mendocino Janitorial Services
Solicitation number
W912P718T0002
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File Type Posted
QA.docx DOCX document
Lin_Item.xlsx XLSX spreadsheet
FAR_Provisions.pdf PDF
Line_Item.pdf PDF
Map.pdf PDF
WAGE_DETERMINATION.pdf PDF
Appendix_B.pdf PDF
PWS.pdf PDF
Appendix_A_Cleaning_Schedule.xlsx XLSX spreadsheet

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Text version

SOLICITATION NUMBER: ___________________________________

PROJECT TITLE: __________________________________________________

PLEASE COMPLETE ALL REQUESTED INFORMATION

Name: _______________________________________________________ Company name: ________________________________________________ Street Address: _____________________________________________________ City: ____________________________ State: ________ Zip: _________ Phone number: ___________________________________________ DUNS: _________________________________ CAGE Code: ______________ Will you be performing this Work?

_____ Yes (list experience) _____ Yes, with help of Subcontractor (Please list experience of your firm and Subcontractor) Employee / Subcontractor’s Name: ___________________________________________ ** FAR 52.219-14 requires that at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern.

Number of Employees who will be working on this contract:

Full Time: _____________ Part Time: ___________ Seasonal: ___________ Do you and your Subcontractor have Commercial Cleaning Experience?

________ Yes Years: ____________ Months: __________ _________ No _________ N/A

EXPERIENCE #1

Self or Subcontractor? ___________________________________________ Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________ Reference Telephone Number: ___________________________________ Additional Information:

EXPERIENCE #2

Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________

EXPERIENCE #3

Job Title: _____________________________________________________ Date work performed: __________________________________________ Reference name: _______________________________________________

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