Attachment 6 - Past Performance Information Form.docx

DOCX document 47 KB Posted

Attached to
NMCC Facility Maintenance Services Federal contract opportunity
Solicitation number
FA701424R0069
Issued by
Department of the Air Force Headquarters District Washington

About this file

This document is a Past Performance Information Form related to a federal contract opportunity for NMCC Facility Maintenance Services (Solicitation #FA701424R0069).

The form provides details on the offeror's past performance, including the contract title, agency/customer, contract number, type, period of performance, original/current contract value, description of the effort, completion dates, customer points of contact, unique aspects of the contract, how the experience applies to the functional areas, key individuals, and compliance with small business and subcontracting goals. The offeror is required to complete this form to demonstrate their relevant past performance in support of the instant acquisition.

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Text version

PAST PERFORMANCE INFORMATION FORM

NMCC Facilities Maintenance (FA701424R0069)

PAST PERFORMANCE REFERENCES THAT ADDRESSES THE TASK AND FUNCTIONAL AREAS OF THE PWS

A.
OFFEROR IDENTIFICATION

1. Company/Division Name:

2. CAGE Code:

3. DUNS 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).

B.
PROGRAM TITLE
C.
CONTRACT SPECIFICS

1. Contracting Agency/Customer:

2. Contract Number:

3. Contract Type:

4. Period of Performance:

5. Total Number of FTEs

6. Original Contract $ Value:

(Do not include unexercised options)

7. Current Contract $ Value:

(Do not include unexercised options)

8. If Amounts for 6 and 7 above are different, provide a brief description of the reason:

D.
BRIEF DESCRIPTION OF EFFORT AS PRIME SUBCONTRACTOR (Mark One)

(Indicate whether it was development and/or production, or other acquisition phase (or Service) 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/Site Manager:

a) Name

b) Office

c) Address

d) Telephone

e) FAX Number

f) E-Mail Address

2. Contracting Officer:

a) Name

b) Office

c) Address

d) Telephone

e) FAX Number

f) E-Mail Address

3. Administrative Contracting Officer:

a) Name

b) Office

c) Address

d) Telephone

e) FAX Number

f) E-Mail Address

G.
ADDRESS ANY TECHNICAL (OR OTHER) AREA ABOUT THIS CONTRACT/ PROGRAM CONSIDERED UNIQUE
H.
ILLUSTRATE HOW YOUR EXPERIENCE/KNOWLEDGE ON THIS PROGRAM APPLIES TO THE FUNCTIONAL AREAS LISTED BELOW:
I.
KEY INDIVIDUALS

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

Name
Referenced Program

Contractual Role Proposed Contractual Role

J.
COMPLIANCE WITH FAR 52.219-8, UTILIZATION OF SMALL BUSINESS CONCERNS (if applicable)

(Include relevant information concerning your compliance on the submitted contract.)

K.
SUBCONTRACTING PLAN PLANNED/ACHIEVED GOALS (if applicable)

(Identify whether a subcontracting plan was required by the contract you are submitting. If so, identify, in percentage terms, the planned versus achieved goals during contract performance. If goals were not met, please explain.)

Subcontracting Plan Required: YES NO (Mark One)

Category
Planned
Achieved

a) Small Business

b) Small Disadvantaged Business

c) Service Disabled Veteran Owned Business

d) Veteran-Owned Small Business

e) Women-Owned Small Business

f) HUBZone Small Business

Explanation if goals were not met:

L.
NATURE OR PORTION OF THE WORK ON THE PROPOSED EFFORT TO BE PERFORMED BY THE BUSINESS ENTITY LISTED IN SECTION K (if applicable)

(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)).

M.
CONTINUATION FOR ITEMS A THROUGH L

(The offeror may provide additional information or explanation for Items A through L, above, if necessary. The offeror must clearly identify the applicable Item(s) by Letter/Number for which the additional information or explanation applies.)

Past Performance Information Form Attachment 6 Page 1 of 6

File details come from the government source that posted it. Updated .