ATTACHMENT A-PastPerformanceInformation.docx

ATTACHMENT A: PAST PERFORMANCE INFORMATION

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

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. The number of past efforts shall be limited to six for the prime Contractor and three for each Subcontractor. Past performance shall demonstrate your ability to perform the proposed effort.

Offeror Name (Company/Division):

CAGE Code:

DUNS Number:

(NOTE: If the company or division performing this past or current effort is different than the Offeror or if the relevancy of this effort, or 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.)

Program Title:

Contract Title:

Contract Agency or Customer:

Contract Number:

Contract Type:

Period of Performance:

Original Contract Value ($): (Do not include unexercised options)

Current Contract Value ($): (Do not include unexercised options)

If Amounts for 5 & 6 above are different, provide a brief description of the reason:

Brief Description of Effort and highlight portions considered most relevant to the current acquisition:

Was this effort as Prime (Y/N)_________ Or Subcontractor (Y/N)_______________

Completion Date:

Original Date:

Current Schedule:

Estimate at Completion:

How Many Times Changed:

Primary Causes of Change:

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.)

c. Administrative Contracting Officer:

Email:

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

Illustrate how your experience on this program applies for each of the applicable Factors, described in the “Evaluation Factors for Award” Section of this RFP .

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

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

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 or subsidiary related to the prime (define relationship).