Att_4_Org_Exp_Reference_Info_Sheet.docx
DOCX document 42 KB Posted
- Solicitation number
- N6600126R0002
About this file
This is a Reference Information Sheet template used to document organizational experience and past performance for proposal submissions to the Cyberspace Science, Research, Engineering and Technology Integration Small Business Multiple Award Contract (MAC) solicitation N66001-26-R-0002 issued by Naval Information Warfare Center Pacific (NIWC Pacific).
The form requires offerors to provide comprehensive details about relevant past contracts, including reference organization name and address, technical and contracting points of contact with full communication details, contract control and task order numbers, principal contract type, award value, award date, and period of performance. Offerors must document actual work dates, work location, and current work status (continuing on/behind schedule, completed, terminated for convenience/default, or other conditions), along with amounts invoiced to date. The form requires certification that contract work descriptions reference only work performed since January 1, 2021, and offerors must provide a detailed summary description of contract work explaining its relevance to one or more Key Areas as defined in the solicitation evaluation criteria. This summary description must be submitted as a separate addendum following L-215-PAC001 submission formatting requirements and page limitations specified in the solicitation's Paragraph 3.1(b). The template does not specify individual reference requirements or quantity limits.
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Text version
Attachment 4 Reference Information Sheet
| Reference No. |
| Select Reference No. that corresponds with Organizational Experience Matrix |
| REFERENCE CONTACT INFORMATION |
1. Complete Name of Reference (Government agency, commercial firm, or other organization) Click or tap here to enter text.
2. Complete Address of Reference (Government agency, commercial firm, or other organization) Click or tap here to enter text.
3. Technical Point of Contact of Reference Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Phone No.: Click or tap here to enter text.
Email: Click or tap here to enter text.
4. Contracting Point of Contact of Reference Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Phone No.: Click or tap here to enter text.
Email: Click or tap here to enter text.
REFERENCE CONTRACT INFORMATION
5. Control Number (e.g., Contract No.)
Click or tap here to enter text.
6. Task Order No. (if applicable) Click or tap here to enter text.
7a. Principle Contract Type:
Choose an item.
8. Contract Award Value (e.g., Contract price, Est. Cost & Fee, Target Cost & profit/fee (as applicable)) Click or tap here to enter text.
7b. If Other, please specify:
Click or tap here to enter text.
9. Award Date (MM/DD/YY):
Click or tap here to enter text.
10. Reference Period of Performance (MM/DD/YY)
Start Date: Click or tap here to enter text.
End Date: Click or tap here to enter text.
11. Contains Small Business Subcontracting Plan (FAR 52.219-9)? Choose an item.
STATUS OF REFERENCE
| 12. Actual Work Dates (MM/DD/YY) |
| 13. Work Location: |
Click or tap here to enter text.
Start: Click or tap here to enter text.
End (if applicable): Click or tap here to enter text.
14. Current status of Work (choose one):
| [☐] | Continuing, on schedule | |
| [☐] | Continuing, behind schedule | |
| [☐] | Completed, no further action pending or underway | |
| [☐] | Completed, routine administrative action pending or underway | |
| [☐] | Completed, claims negotiations pending or underway | |
| [☐] | Completed, litigation pending or underway | |
| [☐] | Terminated for Convenience | |
| [☐] | Terminated for Default | |
| [☐] | Other (explain) |
15. Amount Invoiced To Date: Click or tap here to enter text.
REFERENCE ORGANIZATIONAL EXPERIENCE INFORMATION
16. The Offeror ☐ certifies ☐ does not certify (choose one) that the summary description of contract work provided in response to Block 17 below only describes work performed since 01 January 2021.
17. Provide a summary description of the contract work explaining its relevance with respect to one or more of the Key Areas. Clearly format the response to separate the discussion for each Key Area. Do not provide a consolidated response for multiple Key Areas. In evaluating the offeror’s experience in each individual Key Area, the Government will consider only the text designated in the summary description of contract work for that particular Key Area.
The summary description provided for this Reference shall not be provided within this form. The summary description shall be provided as an addendum to this form meeting the formatting requirements of L-215-PAC001 SUBMISSION OF PROPOSALS and page limitations set forth in Paragraph 3.1(b).
N66001-26-R-0002 Version 2/28/25
File details come from the government source that posted it. Updated .