20-000963_PAST_PERFORMANCE_QUESTIONNAIRE.docx

PAST PERFORMANCE QUESTIONNAIRE

Soliciation # 20-000963

Please complete this Questionnaire and email to Christopher Lauver, Contract Specialist Email: christopher.lauver@nih.gov

We are currently in the process of preparing our proposal for Solicitation Number 20-000963. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance in therefore requested.

Please complete this Questionnaire and email to Contract Specialist, Christopher Lauver.

email: christopher.lauver@nih.gov

If you will not be available for verification of this past performance evaluation, please indicate another POC for the Contracting Officer to contact.

Alternate POC name:_____________________________________________________________

Alernate POC phone number:______________________________________________________

Alternate POC e-mail address:_____________________________________________________

Thank you.

NAME OF OFFEROR:

Phone: Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number:___________________________________________

2. Contract Value:________________________________________________________

3. Period of Performance:__________________________________________________

4. Brief Description of Products/Services Provided: _________________________________________________________________________________________________________________________________________.

5. Name of Person Completing Questionnaire:_________________________________ Agency/Company: _____________________________________________________ Title:______________________________Phone:_____________________________