Attachment_C_-_Relevant_Experience_Form.docx

Relevant Experience Form

Provide the information requested in this form for each experience reference.

A. Offeror Name (Company/Division):

*Please identify if you are a teaming member or subcontractor with the prime

Cage Code:

DUNS Number:

(NOTE: If the company or division performing this effort is different than the offeror please provide an explanation.).

B. Program/Project Title:

C. Contract Specifics:

1. Contracting Agency or Customer:

2. Contract Type:

3. Period of Performance:

4. Original Contract $ Value (Including unexercised options):

Source Selection Information – See FAR 2.101 and 3.104

RFQ# 1625DC-19-Q-00027

Attachment C Relevant Experience Form

5. Estimated completion date:

D. Enter below a brief description of the work performed

E. Primary customer points of contact. (For Government contracts/orders, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

Name

Office

Address

Telephone

E-Mail

F. Describe the relevancy of this work to this effort as described in the PWS. The more similar the scope and complexity of the experience the higher level of confidence the Government will have in the Offeror.