ATTACHMENT D2 Past Performance Information Form (1).docx

SOLICITATION # 1305M223QNMAN01111 FY24 FH DD

ATTACHMENT D2

PAST PERFORMANCE INFORMATION FORM

Form of

CONTRACTOR NAME:

AGENCY OR CLIENT:

1. Refer to Section E of the Solicitation, RFQ PROVISIONS

** * The offeror shall complete this form in its entirety for each contract identified in the offeror’s Volume I – Past Performance Proposal.***

2. Check one of the following statements:

CPARS - The referenced Contract Number has a completed CPAR and can be located in the Past Performance Information Retrieval System (PPIRS).

Past Performance Questionnaire (Fill-in Data under item 3 prior to sending to Agency/Client POC)

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 Contract Specialist, Andre Frantz, email Andre.Frantz@noaa.gov, prior to the closing date of the solicitation.

3. Provide the following data in its entirety.

a. Contract Number and 2 client points of contact with telephone numbers: _____________________

b. Ship Name, Hull Number:

c. Dollar Value of the contract (Original: $ and Final: $ )

d. Type of service performed and whether Prime or Sub Contractor: Type: , Prime or Sub:

e. Contract performance period at the start of the contract: Start: End:

f. Actual performance dates upon completion: Begun: Completed:

g. Contract Type:

h. Percentage of growth in contract price (Additional work divided by award price) and the extent of Subcontracting:

Growth Percentage: % Extent of Subcontracting:

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 August 7, 2023 AT 10:00 AM, Eastern.