Attachment-7_Chem_Toilet_Performance_Information_Form_(PIF).pdf

Attachment 7 to FA9301-20-R-0005: PERFORMANCE INFORMATION FORM (PIF)

Provide the information requested in this form for each contract/program (citation) 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 length of each submission and the number of citations submitted to the limitations set forth in 52.212-1 (See Factor 3a) of the solicitation

A. Offeror Name (Company/Division): _____________________________________________ CAGE Code: ____________________ DUNS Number: ____________________ Program/Contract Title: __________________________________________________________ Offeror's Role in Contract (e.g., Prime, Sub, Partner, etc.): ______________________________ If Other than the Prime Offeror, Identify Prime Offeror: ________________________________

(NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort is impacted by any company/corporate organizational change, note these changes.)

B. Program Title: _______________________________________________________________

C. Contract Specifics:

01. Contracting Agency or Customer: ____________________________________________

02. Contract Number: ___________________________________

03. Task/Purchase Order Number (if any): __________________________________

04. Contract Type (e.g., Firm-Fixed Price, Cost Plus, Time and Material, etc.): ___________

05. Original Period of Performance (Start & Stop Dates including exercised options): ______

06. Current Period of Performance (Start & Stop Dates including exercised options): ______

07. If Amounts for 5 and 6 above are different, provide a brief description of the reason:__________________________________________________________________

08. Original Contract Value ($) to include base and option periods; specify only the value of the portion performed by the offeror: _________________________________________

09. Current/Final Contract Value ($) to include base and option periods; specify only the value of the portion performed by the offeror: $_________________________________

10. If Amounts for 8 and 9 above are different, provide a brief description of the reason: ___

11. Has the contract been entered into the Contractor Performance Assessment Reporting System (CPARS)? Yes or No

12. Average number full time equivalents on contract employed and supervised by the Offeror: _______________________________________________________________

Attachment 7 to FA9301-20-R-0005 Performance Information Form (PIF) Page 1 of 2

13. Location of Contract Performance: ___________________________________________

D. Brief Description of Effort as ___ Prime or ___ Subcontractor (Please indicate the type of services provided (reference Tasks in Section A), and highlight portions considered most relevant to this acquisition.)

E. Primary Customer Points of Contact: (For Government contracts, provide current information on all three positions noted below. For commercial contracts, provide points of contact fulfilling these same roles.)

01. Program Manager: Name ________________________________________________

Office ___________________________________________ Address _____________________________________

Telephone ___________________________________ Email _______________________________________

02. Contracting Officer: Name ________________________________________________ Office ___________________________________________ Address _____________________________________

03. Administrative Name ___________________________________________________ Office ___________________________________________ Address _____________________________________

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

G. Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported herein. 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: _______________________________________________

Attachment 7 to FA9301-20-R-0005 Performance Information Form (PIF) Page 2 of 2