36C25619R0150-022.docx
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36C25619R0150 D21 PAST PERFORMANCE REFERENCES.docx
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ATTACHMENT D21
PAST PERFORMANCE REFERENCES
REFERENCE 1:
Name of Government or Commercial Organization: Address:
Contract Number:
Brief Description:
| Contractor Performed as: | Prime Contractor | Sub-Contractor |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? Circle YES or NO | |
| If yes, brief explanation: | Point Of Contact/COR: | |
| Title: | Telephone Number: |
Point of Contact’s email address:
Comments:
REFERENCE 2:
Name of Government or Commercial Organization: Address:
Contract Number:
Brief Description:
| Contractor Performed as: | Prime Contractor | Sub-Contractor |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? Circle YES or NO | |
| If yes, brief explanation: | Point Of Contact/COR: | |
| Title: | Telephone Number: |
Point of Contact’s email address:
Comments:
REFERENCE 3:
Name of Government or Commercial Organization: Address:
Contract Number:
Brief Description:
| Contractor Performed as: | Prime Contractor | Sub-Contractor |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? Circle YES or NO | |
| If yes, brief explanation: | Point Of Contact/COR: | |
| Title: | Telephone Number: |
Point of Contact’s email address:
Comments:
GEN030.09.03.15
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