Attachment J.3 - Past Performance Evaluation Form.pdf

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OMB Circular Consulting Services
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DCSC-12-FS-0038
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Past Performance Evaluation Form (Attachment J.3)

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TAX tx?mmCATIrn APRDAVIT

For all w- m 100,000.00, Lhe fobwing dwvit is rKpw:

D.C. Bmpbpt T h ID No.:

u - w Accamt No.:

a-U-Nd No.: '

Tba D.C. Catns EP d m v e r f f y & ~ ~ ~ w f c B 'OlwnrnmGac

m. Rdqdrl%-haibd.olma.-$E-for ~ m a r e ~ # p a ( 1 ) p c a t ~ b o r b , r s ~ m B . C . ~ S c c . ~ ~ 1 4 . -far* ~ L a f k d ~ ~ ~ $ 2 ~ . 0 0 , imp ' * k g n a t m o ~ o r h a n i l t ~ e ( 3 ) ~ . ~ ~ , ss in D.C. COdt SCC. 22-2513.

PAST PERFORMANCE EV&UATXON FOW

(- qp* box)

Page I of2

4. Telephone Nuink of Evaluator:

5. ~typtaf&Gereoeived:

6. S#e Con- Nudm, Amount and period of Pdomamc

7. Remadrs 0x1 Excellent Perfomanw hv ide data supporting this obsmatioh (Conhue on srhaet if needed)

Perfalmmcc BlerrwnEs WtY of M c e T i m e h of Perfo-

8. Ramh on unaccepEable &omawe: Provide data supporting this obsetvation.

(Continue onqmate sheet ifnaeded)

Cost Control

B h R&bm -- --clmnlm , SutWaaion

ExcdIent W Paor Acqtabie Umceqmble

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