B08 - ATTACHMENT A - PAST PERFORMANCE INFORMATION.pdf

ATTACHMENT A

PAST PERFORMANCE INFORMATION

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION

IAW FAR 3.104

Provide the information requested in this form for each contract/program being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. The number of past efforts shall be limited to three (3) for the prime contractor and one

(1) for each subcontractor. Relevancy shall demonstrate your ability to perform the proposed effort.

A. Offeror Name (Company/Division): _____________________ CAGE Code: ______________________ DUNS Number: ______________________

NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes. Refer to the “Organizational Structure Change History” you provided as part of your Past Performance volume.

B. Program Title: _____________________________________

C. Contract Title: _____________________________________________

1. Contract Agency or Customer _______________________

2. Contract Number _______________________

3. Contract Type _______________________

4. Period of Performance _______________________

5. Original Contract $ Value _______________________ (Do not include unexercised options)

6. Current Contract $ Value _______________________ (Do not include unexercised options)

7. If Amounts for 5 and 6 above are different, provide a brief description of the reason

(b) Brief Description of Effort as ____Prime or ____Subcontractor (Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition)

(c) Completion Date:

D. Original date: ____________________________________________ E. Current Schedule: ____________________________________________ F. Estimate at Completion: ____________________________________________ G. How Many Times Changed: ____________________________________________ H. Primary Causes of Change: ____________________________________________

(d) Primary Customer Points of Contact: (For Government contracts, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

Program Manager: Name ____________________________________ Office ____________________________________ Address___________________________________ Telephone____________________________________ Email _________________________________

Contracting Officer: Name____________________________________

Office ____________________________________ Address __________________________________ Telephone____________________________________ Email ____________________________________

Administrative Contracting Officer:

Name ____________________________________ Office ____________________________________ Address ____________________________________ Telephone ____________________________________ Email ____________________________________

(e) Address any technical (or other) area about this contract/program considered unique.

(f) For each of the applicable Factors in Section M, illustrate how your experience on this program applies.

(g) Include relevant information concerning your compliance with FAR 52.219-8, Utilization of Small Business Concerns, on the contract you are submitting.

(h) Identify whether a subcontracting plan was required by the contract you are submitting. If one was required, identify, in percentage terms, the planned versus achieved goals during contract performance. If goals were not met, please explain.

(i) Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported here. Also, estimate the percentage of the total proposed effort to be performed by this entity and whether this entity will be performing as the prime, subcontractor, or a corporate division related to the prime (define relationship).