Attachment 3 (Past Perf. Summary Sheet).docx
DOCX document 24 KB Posted
- Attached to
- LOCAL NATIONALS’ OCCUPATIONAL HEALTH EXAMINATIONS SERVICES CONTRACT, CAMP DARBY, LIVORNO, ITALY
- Solicitation number
- W81K00-26-R-A040
- Issued by
-
Department of the Army Medical Command
About this file
This is a Past Performance Summary Sheet template designed for contractors submitting references in response to Solicitation W81K00-26-R-A040 for Local Nationals' Occupational Health Examinations Services at Camp Darby, Livorno, Italy. The template requires contractors to document one project per sheet, limited to three pages, and capture essential contract and performance metrics including company name, CAGE code, prime or subcontractor status, contract or task order number, and period of performance.
The template mandates submission of current points of contact with email and phone numbers from both the contracting office and end user/customer when possible. Contractors must describe the effort by specifying labor categories, service locations, and number of full-time equivalents (FTEs) utilized. Additionally, contractors are required to provide contract or task order award amounts broken down by base year and up to four option years, and document the project status including performance reporting status, years successfully completed, and any terminations or modifications related to scope changes. This template is part of the solicitation package but does not itself contain specific product or service requirements; rather, it serves as a standardized format for past performance documentation.
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Text version
Past Performance Summary Sheet
Provide the following information for each past performance reference submitted in response to Solicitation. Use one project Summary sheet per project. Limit three pages per project.
Company Name and CAGE:
Company Name:
CAGE:
Sub or Prime?
Contract Number or Task Order number and contract period of performance:
Do not provide IDIQ basic contract numbers. Projects provided under an IDIQ shall reference the Task Order number from which the work was completed.
Contract Number:
Period of performance:
Current point of contact (POC):
Provide current email address and phone numbers. Provide two POCs if possible, one from the contracting office and one from the end user/customer.
1.
2.
Description of effort:
Provide the labor categories, location of services and the number of FTEs performed for this effort.
Location:
Labor Category:
# of FTE:
Contract or Task Order Award Amount (Base and Options):
List the amount of the base year and each option year on the contract.
Base year:
Option 1:
Option 2:
Option 3:
Option 4:
Status of the project:
Identify status of performance reporting and how many years have successfully been completed. Identify any terminations or modifications for scope change.
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