Attachment 3 - Past Performance Information Form.pdf

Attachment 3

PAST PERFORMANCE INFORMATION FORM Form ____ of ____

Name of Offeror:

Contract Number, Order Number, or Job identifier Reference:

Customer (Company) Reference Name & Address Location:

Customer Reference Point of Contact (Full Name & Title):

Customer Telephone Number and E-mail address:

(PLEASE VERIFY):

Total dollar value for this effort including all growth work (definite and option items)

(Show either each fiscal year or calendar year; and dollars):

Period of Performance (Month/Day/Year) From:

To:

No. of Period of Performance Time Extensions:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:

PAST PERFORMANCE INFORMATION FORM Form ____ of ____

Name of Offeror:

Contract Number, Order

No. of Period of Performance Time Extensions:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by

PAST PERFORMANCE INFORMATION FORM Form ____ of ____

Name of Offeror:

Contract Number, Order

No. of Period of Performance Time Extensions:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by