Attachment IV - Past Performance Information Form.docx
DOCX document 20 KB Posted
- Solicitation number
- 1305M223QNWWG0161
About this file
This document is a past performance information form template to be completed by offerors responding to Solicitation 1305M223QNWWG0161 for temperature and relative humidity sensor power supplies and mounting hardware from the Department of Commerce National Oceanic and Atmospheric Administration. Offerors must provide details of relevant prior contracts, including contract numbers, values, award and completion dates, descriptions of work performed, complexity levels, and explanations of similarity to the current solicitation requirements. For any subcontracted aspects, offerors must specify percentages of work performed, services provided, and prime contractor details. References listed must return a completed past performance questionnaire by August 15, 2023.
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Other files
| File | Type | Posted |
|---|---|---|
| 1305M223QNWWG0161 Amend 0003.pdf | ||
| Amendment 0002.pdf | ||
| S100-47004-PickPlace REV - .xlsx | XLSX spreadsheet | |
| S100-47004 REV A.pdf | ||
| Attachment II.b S100-47004-Gerbers.zip | ZIP file | |
| S100-47004-BOM REV -.xlsx | XLSX spreadsheet | |
| RFQ 1305M223QNWWG00161 Questions.xlsx | XLSX spreadsheet | |
| 1305M223QNWWG0161 Amend 0001.pdf | ||
| Attachment III - Schedule B Pricing Amend 0001.xlsx | XLSX spreadsheet | |
| Attachment II TRH Power Supply_Hardware Schematics.pdf | ||
| Attachment III - Schedule B Pricing.xlsx | XLSX spreadsheet | |
| Combined Synopsis Solicitation 1305M223QNWWG0161.pdf | ||
| Attachment IV.a Past Performance Questionaire.docx | DOCX document | |
| Attachment I TRH Power Supply_Hardware Combined Parts list.pdf |
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Text version
SOLICITATION: 1305M223QNWWG0161
ATTACHMENT IV: Past Performance Information Form
PAST PERFORMANCE INFORMATION FORM
Refer to 52.212-1 addendum of Solicitation 1305M223QNWWG0161 Instructions to Offerors, REQUIREMENTS FOR PROPOSAL CONTENT. The offeror shall complete this form in its entirety for each contract identified in the offeror’s Volume I – Technical Submission.
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, Jennifer Roesner and the Contract Specialist, Margaret Williams, via email at jennifer.roesner@noaa.gov and margaret.williams@noaa.gov no later than 12PM ET, August 15, 2023.
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 Work 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):
Complexity of Work (low, moderate, high):
Relevance to the Contract Requirements of RFP 1305M223QNWWG0161 (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 12:00 PM ET, August 15, 2023.
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