36C24518R0046-027.pdf

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104

Multiple Award Task Order Contract (MATOC)

36C24518R0046

ATTACHMENT 5

PAST PERFORMANCE INFORMATION SHEET

PART 1: Provide the following information requested in this format for each of the projects/contracts you intend to have considered for evaluation. Projects may be on-going (at least 2 months of performance) and cannot have been completed any later than 4 years prior to the solicitation release date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you elect to reference.

A. Offeror (Your) Name (Company/Division):

B. Project/Contract Title:

C. Contract Specifics:

1. Description of Effort as __________ Prime or ______Subcontractor

2. Contract Number __________

3. Original Contract $ Value ________ Current/Final Contract $ Value ____________

4. If amounts in 3 above are different, provide a brief description of the reason: ________

5. Completion Date(s):

a. Original Date: ______________________

b. Current Schedule____________________

c. Estimate/Final Completion Date:_____________________

d. Primary cause for Contract Modifications______________

6. Is there a Contractor Performance Assessment Report (CPAR) for this contract? Y or N

NOTE: If the answer to 6 is “NO” ensure there shall be a Past Performance Questionnaire (Attachment

7) completed and returned to the Contracting Officer by the closing date of this RFP.

D. Provide detailed description of the work performed under the contract and describe why you believe the work is VERY REVELANT, RELEVANT, or SOMEWHAT RELEVANT. Address the following:

1. Describe the specific elements of the work performed by your firm.

2. Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on projects awarded under this MATOC. Should you intend to use these same subcontractors, please list their company names and describe their principal areas of work that they will perform.

3. Address any technical areas about this project you consider uniquely relevant to this MATOC solicitation.

4. Offerors are strongly encouraged to include with their proposals information on problems encountered on relevant projects and the specific corrective actions taken to remedy the problems.

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104

Multiple Award Task Order Contract (MATOC)

36C24518R0046

E. Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR); include a current phone number, email address and address for each.

Company Name:

Point of Contact: Title: E-mail: __

Office Phone: _______________ Fax: _

Address of Record:

PART 2: Additional offeror information required, but not project specific. This information need only be provided once in your submission package.

A. Other Past Performance Considerations. Information provided, shall be limited to the period starting 4 years prior to the solicitation release date and may include the following:

1. Effectiveness of value engineering (VEC) proposals you submitted on prior contracts. (Provide a brief description; impact on cost, schedule, efficiency or quality; contract number; name and phone number of customer benefiting from the VEC).

2. Professional/Industry awards (Identify award type, date of award and copy of certificate if applicable), Letters of appreciation, recognition or commendations

3. Discuss unique skills and accomplishments (Explain unique skills and/or accomplishments and provide supporting information for verification).

B. Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR); include a current phone number, email address and facsimile number for each.

Company Name:

Point of Contact: Title: E-mail: __

Office Phone: _______________ Fax: _

Address of Record: