Attachment L4_Past Performance Information Form.pdf

Attachment L4 - PAST

PERFORMANCE INFORMATION

FORM (PPIF)

Past Performance Reference No.

Provide the information requested in this form for each one of the present or past contracts you have identified. Provide a separate completed form for each contract identified. Attach a separate sheet if additional space is needed.

A. Current Offeror (Company/Division):

CAGE Code:

UEI Number:

(NOTE: If the company or division performing this past or present effort is different from the current Offeror, note this fact below. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume).

B. Project Title:

C. Contract Specifics:

1. Complete Name of Customer:

2. Customer Address and Telephone #:

3. Contract Number or Citation:

4. Type of Contract:

5. Period of Performance:

6. Initial Contract Price: $

7. Final Amount Invoiced/Amount Invoiced to Date: $

8. Original completion date:

9. Current scheduled completion date:

10. Estimated completion date:

OR Estimated Percent Completion:

11. Number of contract modifications:

12. Enter primary cause for contract changes below:

D. Description of Work Prime or Subcontractor.

E. Describe how the work under this contract relates to the experience cited by the Offeror in its present proposal.

F. Self-Assessment of past performance record. Provide information of any problems encountered and your corrective actions.

G. Address below any technical (or other) issues about this contract considered particularly relevant to the current solicitation.

H. Summarize contract issues relative to the number and severity of quality deficiencies recorded/contract discrepancy reports issued, cure notices, show cause letters, termination for default or cause, disputes, claims, latent defects; and corrective actions taken for this contract reference.

I. Current Status of Contract (Select as applicable):

[ ] Work Continuing – On Schedule

[ ] Work Continuing – Behind Schedule

[ ] Work Completed – Litigation Pending or Underway

[ ] Work Completed – No Further Action Pending or Underway

[ ] Work Completed – Routine Administrative Action Pending or Underway

[ ] Request For Equitable Adjustment(s) Negotiations Pending or Underway

[ ] Claims Negotiations Pending or Underway

[ ] Terminated for Convenience

[ ] Terminated for Default

[ ] Other (Explain)

J. Primary customer points of contact. (For Government contracts/orders, provide current information on all three individuals. For commercial contracts, provide points of contact filling these same roles.)

1. Program Manager and/or Site Manager

2. Procurement Contracting Officer

3. Administrative Contracting Officer

Name:

Office:

Address:

Telephone:

FAX #:

E-Mail:

Additionally, for those efforts where the offeror is cognizant of unfavorable and/or marginal past performance ratings/reports previously assessed by customers or clients, but feel that significant progress has been made but not yet credited or formally documented, provide the program name, contract number, customer location and a narrative explaining "fixes" made to date, or any other information regarding the unfavorable/marginal assessment.

It is not presumed that the offeror's performance has been perfect. Rather, the proposal should contain evidence of the offeror's ability to isolate the root causes of problems and should describe programs or actions taken to resolve those causes. Demonstrated corrective actions (not just planned or promised), and the overall work record will be considered. Problems not addressed by the offeror, but found by the Government during the evaluation of the information in this volume, will be assumed to still exist. Note: In the case of Contractor Performance Assessment Report System (CPARS), if your input has already been provided and the rationale/circumstances have not changed, DO NOT repeat them here.