Attachment J-11. Past Performance Relevancy Surveys

Provide the following information requested in this form for each of the contracts you intend to have considered for Past Performance evaluation.

Provide concise information regarding your performance on the contract you elect to reference.

Company Name: Click or tap here to enter text.

Project Information:

Contract title: Click or tap here to enter text.

Contract number: Click or tap here to enter text.

Work Performed as:

PRIME: ☐Subcontractor: ☐

Contract Type: Click or tap here to enter text.

Dollar Value:

Original: Click or tap here to enter text.
Final: Click or tap here to enter text.

Forecasted/ Actual Completion Date: Click or tap here to enter text.

Work was with: Commercial ☐ Fed. Gov't ☐ Local/City/State Gov't ☐

Information of Company providing evaluation information

Company name: Click or tap here to enter text.

Assessor’s name and Title: Click or tap here to enter text.

Telephone Number: Click or tap here to enter text.

Email Address: Click or tap here to enter text.

Work Description: Descriptions must address the following: Provide detailed description of the work performed under the contract and describe why you believe the work is relevant. Describe the specific elements of the work performed by your firm Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on projects awarded under this contract. Should you intend to use these same subcontractors, please list their company names and described their principal areas of work that they will perform Address any technical areas about this project you consider uniquely relevant to this solicitation

*The response shall not exceed page 2. Any information provided beyond page 2 will not be evaluated.