Attachment 6 - Past Performance Data Worksheet.docx

(Attachment # 6)

VEHICLE TOWING, APPRAISAL, STORAGE, MAINTENANCE & DISPOSAL SERVICES

DISTRICTS OF TEXAS (NORTHERN, EASTERN, AND WESTERN) AND

DISTRICTS OF OKLAHOMA (NORTHERN, EASTERN, AND WESTERN)

SOLICITATION NO.: 15M50022QA4400009

PAST PERFORMANCE DATA WORKSHEET

1. Name of Contracting Activity/Organization:

2. Contract Number:

3.

Contract Type:

Negotiated

Sealed Bid

Labor Hour (IDIQ

Cost reimbursement

Fixed Price

Other

4 Total Contract Value: $

5. Status: Active Completed

6.

Date of Award:

Original estimated completion date:

Actual completion date:

Explanation for variance:

7. Nature and Scope of the work:

8. Contracting Officer & Telephone Number: E-mail address:

9. Program Manager & Telephone Number: E-mail address:

10. Administrative Contracting Officer (if different from #8): E-mail address:

11. Contracting Officer’s Representative (COR) and Telephone Number:

E-mail address:

12. List of major subcontracts and their contribution to the overall value of the contract (percentage):

13. Any problems or mitigating circumstances which the offeror would like to have known to balance the evaluations of those named above:

A SEPARATE WORKSHEET MUST BE COMPLETED FOR THREE (3) FEDERAL GOVERNMENT OR COMMERCIAL CONTRACTS PERFORMED DURING THE LAST 3 YEARS THAT ARE SIMILAR AND RELEVANT TO THE PERFORMANCE REQUIREMENTS IN THE SOLICITATION.

-USE ADDITIONAL PAPER IF NECESSARY-