Attachment 3 - Reference Information Sheet.docx

REFERENCE INFORMATION SHEET

Please fill out one for each reference provided in your proposal

1. Complete name of commercial firm, Government agency or other organization awarding contract

2. Complete Address

3. Contract Number or other reference

4. Date of Contract Award

5. Date work started (within the last five (5) years prior to the issue date of subject solicitation.)

6. Date work was or will be completed

7. Total Contract Amount (including all options).

8. Technical point of contact (name, title, address, telephone no. and email address)

9. Contracting or purchasing point of contact (name, title, address, telephone no. and email address)

10. Location of work (country, state or providence, county, city)

11. Description of contract work (Describe complexity, number of tasks, scope, and type of work. Attach an explanation of any performance problems or other conflicts with the customer. Describe any litigation, pending, on-going, or completed. Use a continuation sheet, if necessary.)

12. Current status of contract (choose one):

Work continuing, on schedule Terminated for convenience

Work continuing, behind schedule Terminated for default Work complete, no further action pending or underway Other (explain)

Work completed, routine administrative action pending or underway Work completed, claims negotiations pending or underway

Work completed, litigation pending or underway