Attachment B -Past Performance Information Form.pdf

SOLICITATION: 1305M223QNCNJ0139

ATTACHMENT: B Past Performance Information Form

PAST PERFORMANCE INFORMATION FORM

Refer to Section D of Solicitation 1305M223QNCNJ0139, Instructions to Offerors. The offeror shall complete this form in its entirety for each of the three (3) most relevant contracts within the past three (3) years from the RFQ closing date. This form will not be included in the page count for Volume I – Non-Price Business Solution.

Check one of the following statements:

CPARS - referenced Contract Number has a completed CPARS.

Past Performance Questionnaire, Check statement below and fill-in all data in tables below prior to sending to Agency/Client point of contact

The Point of Contact or Project Manager associated with the work completed under the referenced Contract Number has been sent this form and the Past Performance Questionnaire to complete and return to both the Contracting Officer, Nicole Lawson and the Contract Specialist, Kirstin Bryant, via email at Nicole.Lawson@noaa.gov and Kirstin.Bryant@noaa.gov no later than the closing of the solicitation.

CONTRACTOR INFORMATION

Contractor Name: Contractor Address:

Unique Entity Identifier (UEI) Number: Contractor Point of Contact Name, Phone Number, and Email Address:

CONTRACT INFORMATION

Contract Number and Delivery/Task Order Number (if applicable):

Contract Type:

Dollar Value (Annual and Total):

Original Contract Price and Final Contract Price (if different, explain):

Date of Contract Award:

Contract Completion Date and Actual Completion Date (if different, explain):

Contract Title:

Contract Location:

Contract Agency or Commercial Entity:

Contract Agency or Commercial Entity Reference Name, Phone Number, and Email Address:

PROJECT DESCRIPTION

Description of Services Performed (including work performed and results achieved; description of the methodology, tools, and processes utilized in performing the work; number of contractor personnel performing per year; adherence to the contract schedule and cost; and problems encountered and corrective actions taken):

mailto:Kirstin.Bryant@noaa.gov

Complexity of Work (low, moderate, high):

Relevance to the Contract Requirements of RFP 1305M223QNCNJ0139 (detailed explanation demonstrating similarity of the contract in terms of scope, dollar value, and complexity):

SUBCONTRACTING INFORMATION

Specify Prime, Subcontractor, Joint Venture, or Other:

Percentage of Project Work Performed (differentiate between the overall contract effort and subcontractor effort) and Specific Services Performed (clearly detail the aspects of the work in the solicitation that the subcontractor is proposed to perform):

Prime Contractor Name and Phone Number (if subcontractor):

NOTE: It is the responsibility of the Offeror to follow‐up and to encourage references to submit the questionnaire prior to the solicitation closing date of the solicitation.