03 Sol Att D Past Performance Information Form.docx

SOLICITATION: 1305M224R0017

ATTACHMENT: D Past Performance Information Form

PAST PERFORMANCE INFORMATION FORM

Refer to Section L of the subject solicitation, Instructions to Offerors, REQUIREMENTS FOR PROPOSAL CONTENT. The offeror shall complete this form in its entirety for each contract identified in the offeror’s Volume I, Factor II: Technical Proposal.

Check one of the following statements:

CPARS - referenced Contract Number has a completed CPARS.

Past Performance Questionnaire, Check statement below and fill-in all data in tables below prior to sending to Agency/Client point of contact

The Point of Contact or Project Manager associated with the work completed under the referenced Contract Number has been sent this form and the Past Performance Questionnaire to complete and return to both the Contracting Officer, Heather Coleman and the Contract Specialist, Spencer Matsushima, via email at heather.l.coleman@noaa.gov and spencer.matsushima@noaa.gov no later than the due date of the solicitation.

CONTRACTOR INFORMATION

CONTRACT INFORMATION

Contract Number and Delivery/Task Order Number (if applicable):

Contract Type:

Dollar Value (Annual and Total):

Original Contract Price and Final Contract Price (if different, explain):

Date of Contract Award:

Contract Completion Date and Actual Completion Date (if different, explain):

Contract Title:

Contract Location:

Contract Agency or Commercial Entity:

Contract Agency or Commercial Entity Reference Name, Phone Number, and Email Address:

PROJECT DESCRIPTION

Description of Services Performed (including work performed and results achieved; description of the methodology, tools, and processes utilized in performing the work; number of contractor personnel performing per year; adherence to the contract schedule and cost; and problems encountered and corrective actions taken):

Complexity of Work (low, moderate, high):

Relevance to the Contract Requirements of the subject solicitation (detailed explanation demonstrating similarity of the contract in terms of scope, dollar value, and complexity):

SUBCONTRACTING INFORMATION

Specify Prime, Subcontractor, Joint Venture, or Other:

Percentage of Project Work Performed (differentiate between the overall contract effort and subcontractor effort) and Specific Services Performed (clearly detail the aspects of the work in the solicitation that the subcontractor is proposed to perform):

Prime Contractor Name and Phone Number (if subcontractor):

NOTE: It is the responsibility of the Offeror to follow‐up and to encourage references to submit the questionnaire prior to the solicitation closing date.