70RDAD20R00000007 Attachment 2.pdf

70RDAD20R00000007– Attachment 2 Page 1 of 2

Attachment 2 Past Performance Information Form

(Quoters are required to complete this form for no more than three (3) separate relevant contracts/projects)

Quoter:

Company Group / Division:

Program, Project, Or Task

REFERENCE INFORMATION

1 Customer Name:

2 Address:

Customer Info: Contracting Contact Program / Project Manager or

COR

3 Name & Title:

4 Organization:

5 Address:

5 Phone No.:

6 Fax No.:

7 E-mail:

Contract Number:

Past Performance Information Retrieval System (PPIRS) Record Available?

9 Contract Type (e.g. contract, BPA, task order) and pricing type (e.g. fixed price, cost reimbursement):

70RDAD20R00000007– Attachment 2 Page 2 of 2

10 Dollar Value (Not-to Exceed):

Cumulative funded amount:

11 Project Start Date Estimated/Actual Completion Date:

12 Current status, e.g. completed and/or in progress

Description of Work Performed and Relevance to Requirements in this RFQ

Problems Encountered and Resolutions

Past Performance Information Form