Attachment 4 - Past Performance Fact Sheet.docx

Controlled Unclassified Information When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Section L Attachment: Past Performance Fact Sheet

TO BE COMPLETED BY OFFEROR

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

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

E. Program Title:

F. Brief Program Description:

G. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

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):

I. Description of work performed:

J. How is this project relevant?

K. Explain corrective actions taken in the past, if any, for substandard performance problems, such as cost overruns, extended performance periods, numerous warranty calls, etc.

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

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

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: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / fax number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Signature of Offeror

Controlled Unclassified Information Page 1 of 2