Attachment D - Past Performance Information (PPI) Contract Reference Sheet.docx

PAST PERFORMANCE INFORMATION (PPI) CONTRACT REFERENCE SHEET

Provide the information requested in this form for each contract/program being submitted. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted.

A. Offeror Name (Company/Division): ____________________ CAGE Code: ____________________ UEI 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. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume).

B. Program Title: ____________________

C. Contract Specifics:

1. Contracting Agency or Customer _____________________________________________

2. Contract Number__________________________________________________________

3. Contract Type __________________________

4. Period of Performance __________________________

5. Original Contract $ Value _________________ (Do not include unexercised options)

6. Current Contract $ Value _________________ (Do not include unexercised options)

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

D. Brief Description of Effort as __Prime or __Subcontractor

(Provide a brief description of the service provided and actual work performed under this contract reference. Highlight portions considered most relevant to JOC IDIQ. If submitting a reference for a subcontractor, teaming partner, joint venture, or a corporate division related to the offeror, describe the nature and portion (percentage) of the work to be performed on the JOC IDIQ by the company referenced on the PPI sheet, and clearly define the relationship. Indicate place(s) of performance:

- State if performance was in multiple locations. If so, specify locations.

- State if performance serviced state or federal Government and provide details.

- State if performance serviced the Department of Defense, and provide details.)

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 Manager and/or Site Manager:

Name ____________________ Office ____________________ Address________________________________________ Telephone__________________ FAX Number_______________

2. Contracting Officer:

Name ____________________ Office ____________________ Address________________________________________ Telephone__________________ FAX Number_______________

3. Administrative Contracting Officer:

Name ____________________ Office ____________________ Address________________________________________ Telephone__________________ FAX Number_______________

G. Explain how your experience and the experience of the contract references provided for your teaming partners, joint ventures, major or critical subcontractors is relevant IAW the relevancy criteria.

H. 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).

I. IAW FAR 15.305(a)(2)(iii), relevant experience from predecessor companies, key personnel, or subcontractors may be evaluated. If relying on experience of any of the entities, clearly explain “whose” past performance, and “how” the past performance is relevant to the proposed effort.