Statement of Single Largest Completed Contract Similar to the Project to be Bid within the last three (3) years:
Project Name to be bid: ________________________________________________________
Project No. to be bid : ________________________________________________________
Name of Contract Company Name Items Amount of Contract Date of Completion
Note: This statement shall be supported with:
1. Certificate of Acceptance by the end-user or Official Receipt (O.R.) or Sales Invoice (S.I.) - (submission during opening of bid/s)
2. Contract or Purchase Order - (submission during opening of bid/s)
Submitted by : _________________________________________
(Authorized Representative and Signature)
Date : _________________________________________
NOTE: PLEASE USE THE OFFICIAL FORM/PRO FORMA ISSUED BY THE BAC-GOODS AND SERVICES, OTHER FORMAT WILL NOT BE ACCEPTED
QCG.PD.DASD.F.20