47QFRA20Q0004 - Attachment 4 - Past Performance Data Sheet.pdf

ID08200023, Attachment 4

Past Performance Data Sheet

2. Project No. (check one) : #1 #2 #3

Submission of Master contract vehicles (e.g., Blanket Purchase Agreements, Indefinite Delivery/Indefinite Quantity contracts) is not permitted. Each Past Performance Data Sheet shall be for one contract or one order.

Vendor Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

3. Contract Number: Delivery/Task Order Number:

Title:

Location:

Award Amount:

Final Price:

4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

5. Type of Contract/Task Order: (Check ALL that apply)

Firm-Fixed Price Cost/Time and Material Other (explain):

6. Customer/Owner Name:

Customer POC:

Organization:

POC Phone Number:

POC E-mail address:

Government POC (if other than POC listed above):

Organization:

POC Phone Number:

POC E-mail address:

7. Provide a detailed description of the project and the relevancy to the project requirements of this RFQ. Within the description, identify how the selected project meets the definition of “Similar Contract/Task Order work.”

8. Other Information: