0004 Past Performance Reference Sheet.pdf

PAST PERFORMANCE INFORMATION FORM

CONTRACTOR MUST COMPLETE

** Experience: Quoters shall describe and provide examples of recent experience in performing the same or similar services of the same scope, magnitude, and complexity, specifically, the Installation of Fuel Tanks and Concrete Pad. Recent is defined as within the last three (3) years.

Name of Vendor:

Contract Number, Order number, or Identifier:

Contract Type (Firm Fixed Price, Cost Reimbursement, or Time and Material):

Government/Employer Point of Contact (Name & Title):

Government/Employer Telephone Number and E-mail Address (PLEASE VERIFY):

Total dollar value for this effort broken into annual increments:

(For ordering vehicles, show both the annual estimated contract amount and the amount of orders actually performed)

Type of Service(s) Provided and Location(s) : Period of Performance:

From:

To:

** Past Performance: Quoters shall demonstrate relevant past performance or affirmatively state that it possesses no relevant past performance. Relevant past performance is performance under contracts or efforts (within the past 3 years) that is of the same or similar scope, magnitude, and complexity to that which is described in the solicitation. Quoters shall submit a maximum of three (3) current/previous contracts performed within the last three (3) years that are of a similar nature to this solicitation.

Quoters shall include on the Past Performance Reference Form: contract number, name and address of the Government agency or commercial entity, description of work/services provided, point of contact with current phone number and e-mail address, date of contract award, period of performance, initial and current contract value, and the extent of subcontracting.

Quoters shall fill out a Past Performance Reference Form for each reference and submit with their quote.

The POCs on the references submitted maybe contacted by the Government to confirm past performance information and the quality of services provided under the reference. Quoters that are newly formed entities or otherwise lack relevant prior contracts should list contracts and subcontracts as required above for all key personnel and applicable resources to be used in the effort being offered (where it may not be easily apparent, also explain the relevance of the past performance).

Quoters are encouraged to describe any problems encountered and corrective actions taken on the identified contracts. NOAA reserves the right to obtain information for use in evaluating past performance from any and all sources, including sources outside the Government.

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation: (NOTE: Vendor should demonstrate that the efforts performed for this reference are similar or directly related to design services)

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts: