Attachment No. 03 - Past Performance Questionnaire.docx
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- W9124G-21-R-0009
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W9124G21R0009
ATTACHMENT 3
PAST PERFORMANCE QUESTIONNAIRE
WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104
SECTION 1: CONTRACT IDENTIFICATION
1. Contractor: _______________________________________________________________________________
1. Cage Code: _________________________________
1. Contract number: _______________________________________
1. Contract type: ______________________________
1. Was this a competitive contract? Yes _____ No _____
1. Period of performance: _________________________________________________________
1. Initial contract cost: $____________________________
1. Current/final contract cost: $_______________________________
1. Reasons for differences between initial contract cost and final contract costs:
1. Description of service provided: ______________________________________________________________
SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION
1. Customer or agency name: _______________________________________________________________________________________
1. Customer or agency description (if applicable): _______________________________________________________________________________________
1. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:
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