Attachment S-1 - Reference Information Sheet.doc

REFERENCE INFORMATION SHEET

1. Contract Number:

2. Contractor (Name and Address):

3. Type of Contract: Firm-Fixed-Price _____ Cost Reimbursement _____ Time and Materials _____

4. Complexity of Work: Difficult _____ Routine _____

5. Description, location, and relevancy of work:

6. Contract Dollar Value: _____________________

Status: Active _____ Completed _____

7. Date of Award: _______________

Contract Completion Date (including extensions): _______________

8. Type and Extent of Subcontracting:

9. Name, Address, Telephone Number, and E-mail Address of the Procuring Contracting Officer, and/or the Contracting Officer’s Representative (and other references—e.g., Administrative Contracting Officer—if applicable):

N5523621R0005

Attachment S-1