Attachment 5 - Past Performance Reference List.pdf

PDF 201 KB Posted

Attached to
Replacement of Vault Doors Federal contract opportunity
Solicitation number
FA301023R0019
Issued by
Department of the Air Force Air Education and Training Command

About this file

This document contains a past performance reference list template for a solicitation seeking replacement of vault doors. It requests information on up to five past performance references including contract details, description of work performed as prime contractor or subcontractor, period of performance, contracting agency and point of contact, contract value, and whether the work was performed by any proposed subcontractors, teaming partners, or key personnel for this opportunity. For any subcontracted work, it asks for additional details on the organization and their role. The solicitation number is FA301023R0019 and is issued by the Department of the Air Force Air Education and Training Command for replacement of vault doors. No further product, pricing, or response deadline details are provided in this template document.

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ATTACHMENT 5

FA301023R0019

MAHG221056 Replace Vault Doors B4002

1 | P a g e

COMPANY NAME:

CONTRACT NUMBER

(task order number(s) required if referencing an IDIQ contract)

Identify if CPAR is available

DESCRIPTION OF WORK PERFORMED

(performed as a prime/sub-contractor)

CONTRACT PERIOD OF

PERFORMANCE (POP)

CONTRACTING AGENCY,

POC/CUSTOMER NAME,

PHONE #, & EMAIL

CONTRACT/

TASK ORDER

VALUE

PERFORMED BY A PROPOSED

SUBCONTRACTOR, KEY

PERSONNEL, OR TEAMING

ARRANGEMENT? (if yes, complete page 2)

Use this space to provide additional information such as comments on any performance deemed unacceptable to customer, or not in accordance with the contract terms and conditions, etc. If additional information is provided for more than 1 contract, identify comments by contract number. Use multiple sheets if necessary.

ATTACHMENT 5

FA301023R0019

MAHG221056 Replace Vault Doors B4002

2 | P a g e

CONTRACT NUMBER

(task order number(s) required if referencing an IDIQ contract)

SUBCONTRACTOR,

TEAMING

ARRANGEMENT, OR

KEY PERSONNEL

DESCRIBE FUNCTION/TASK/3rd PARTY AFFECT ON PERFORMANCE (See Section L, 2(d) through 2(g) answer all questions pertaining to subcontractor, teaming arrangement, or key personnel; indicating affect they had and percentage completed on referenced contract listed on page 1, and affect they will have and percentage they will complete while performing this contract)

CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow1:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow1:
CONTRACT PERIOD OF PERFORMANCE POPRow1:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow1:
CONTRACT TASK ORDER VALUERow1:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row1:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow2:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow2:
CONTRACT PERIOD OF PERFORMANCE POPRow2:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow2:
CONTRACT TASK ORDER VALUERow2:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row2:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow3:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow3:
CONTRACT PERIOD OF PERFORMANCE POPRow3:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow3:
CONTRACT TASK ORDER VALUERow3:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row3:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow4:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow4:
CONTRACT PERIOD OF PERFORMANCE POPRow4:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow4:
CONTRACT TASK ORDER VALUERow4:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row4:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow5:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow5:
CONTRACT PERIOD OF PERFORMANCE POPRow5:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow5:
CONTRACT TASK ORDER VALUERow5:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row5:
Use this space to provide additional information such as comments on any performance deemed unacceptable to customer or not in accordance with the contract terms and conditions etc If additional information is provided for more than 1 contract identify comments by contract number Use multiple sheets if necessary:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow1:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow1:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow1:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow2:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow2:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow2:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow3:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow3:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow3:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow4:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow4:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow4:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow5:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow5:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow5:
2 P a ge:
Text1:

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