16-Attachment 3 - Past Performance Information Sheet.pdf

Executive Office of the President Past Performance Information Sheet

Instructions: This form is to be completed by the Offeror. Failure to accurately complete this form may negatively impact the evaluation of the Offeror’s proposal/quotation under the Solicitation. Only one contract/order or subcontract (e.g., not entire Blanket Purchase Agreements or Basic Ordering Agreements) is permitted per Past Performance Information Sheet.

Contract/Order Identification Number If applicable, also include subcontract identification number.

Description of Products or Services Provide a very brief statement about the nature of products or services rendered (e.g., “Business Support Services for Office of Information”). Additional details regarding performance are to be included in the narrative below.

Contract/Order Status Make appropriate selection.

Contractor Role Make appropriate selection.

Awarding Agency Identify Agency and/or component that issued prime contract/order. If offeror performed as a subcontractor (or other entity not in privity with the Government) include both the identity of the awarding agency and the prime contractor.

Contractor Identification Provide name, address, and DUNS No. of entity performing the contract/order (or, if applicable, subcontract). If contractor identity is different than Offeror, explain the relationship between the entities.

Contract/Order Type Make appropriate selection.

Contract/Order Dollar Value Provide estimate of dollar value of the contract/order (inclusive of unexercised options). If a subcontract, only provide the estimated value of the subcontract.

Period of Performance Provide the start date of performance as well as the actual or potential expiration date (inclusive of unexercised options).

Primary Agency Point of Contract Include the Name, Address, Telephone Number, and E-mail Address of the responsible Contracting Officer, Contracting Officer’s Representative, or other Government Official with cognizance of the Offeror’s performance. If Offeror was a subcontractor, provide information for a responsible party within the prime contractor with cognizance of the Offeror’s performance.

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Description of Work / Explanations Provide a description of the product or services provided, and explain why Offeror’s performance under the contract/order or subcontract is relevant to the product and/or services required by the Solicitation. The Offeror should also provide information that explains any response provided above, if necessary. Additionally, the Offeror should identify any adverse past performance experienced under the contract/order or subcontract, and explain how Offeror addressed the issues.