Attachment 1 - Past Performance Information Sheet - DRAFT.pdf

FA3002-21-R-0024, CDSS-III

Section J – Attachment 1

PAST PERFORMANCE INFORMATION SHEET

Complete the information requested in this form for each contract/program provided as a past performance reference for this acquisition. Provide frank, clear information regarding your performance to include corrective actions taken and submit this form with Volume I, Past Performance.

Please clearly mark which area(s) this contract/program addresses:

Section 1: Contract Identification

A. Contractor (Company/Division):

(NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes.

Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume.)

B. Contractor Cage Code and DUNS:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Period of Performance:

H. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

4. Average annual value:

I. Description of work performed:

J. Was this a competitively awarded contract? ☐ Yes ☐ No

K. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

L. Brief description of any performance issues and corrective measures, if any:

Phase-In/ Phase-Out

Technical Performance

Quality Control Plan

Employee Retention/Attraction

Program Management

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Points of Contact

A. Primary Customer Points of Contact:

(NOTE: For Government contracts provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

1. Program Manager and/or Site Manager:

Name:

Office:

E-mail Address:

Telephone:

FAX Number:

2. Contracting Officer:

Office:

E-mail Address:

3. Administrative Contracting Officer:

Office :

E-mail Address:

Section 4: Contract Specifics

A. For each of the applicable sub-factors under Volume II – Technical Proposal in Section M, describe how the experience on the contract/program is relevant to the primary evaluation areas identified in Section M.5.

B. Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported here. Also, estimate the percentage of the total proposed effort to be performed by this entity and whether this entity will be performing as the prime, subcontractor, or a corporate division related to the prime (define relationship).

C. Specify, by name, any key individual(s) who participated in this program and are proposed to support the instant acquisition, if any. Also, indicate their contractual roles for both acquisitions.

D. Identify whether a subcontracting plan was required by the contract you are submitting. If yes, identify, in percentage terms, the planned versus achieved goals during contract performance. If goals were not met, please explain.