Attachment 4 Past Performance Information.docx

ATTACHMENT 4

RFP FA330026R0022

PAST PERFORMANCE INFORMATION

Provide the information requested in this form for each contract/program being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations set forth at paragraphs 3(a)(4) and 3(e), respectively, of Addendum RFO 52.212-1 Volume 3, Past Performance of this solicitation.

A. Offeror Name (Company/Division): ____________________

CAGE Code: ____________________

UEI Number: ____________________

(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. Program Title: ____________________

C. Contract Specifics:

1. Contracting Agency or Customer ________________________________

2. Contract Number ______________________________

3. Contract Type __________________________

4. Period of Performance __________________________

5. Original Contract $ Value _________________ (Do not include unexercised options)

6. Current Contract $ Value ________________ (Do not include unexercised options)

7. If Amounts for 5 and 6 above are different, provide a brief explanation of the reason ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

D. Brief Description of Effort as __Prime or __Subcontractor (Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition)

E. Completion Date:

1. Original date: ____________________

2. Current Schedule: ____________________

3. Estimate at Completion: ____________________

4. How Many Times Changed: ____________________

5. Primary Causes of Change: _______________________

F. Primary Customer Points of Contact: (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 Name ____________________

Site Manager Office ____________________

Address ____________________ Telephone ____________________

E-mail Address _________________________

2. Contracting Officer: Name ____________________

Office ____________________

Address ____________________

Telephone __________________

E-mail Address ____________________

3. Administrative Name ____________________

Contracting Officer: Name ____________________

Office ____________________

E-mail Address ___ ____________

G. Address any technical (or other) area about this contract/program considered unique.

H. For each of the applicable subfactors under the Addendum RFO 52.212.2, Volume 2, Technical, illustrate how your experience on this program applies to that subfactor.

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

J. Include relevant information concerning your compliance with RFO 52.219-8, Utilization of Small Business Concerns, on the contract you are submitting.

K. 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). (This is especially important if requesting the Past Performance volume early, as the Past Performance Team will not have any other source for this information, which is critical to their relevancy determination)