Attachment 5 -Past Performance Information Form.doc

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Facility Support Services
Solicitation number
DJA08S000028
Issued by

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Attachment 5 -Past Performance Information Form

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Attachment 5

PAST PERFORMANCE INFORMATION FORM
Form ___ of ___

Name of Offeror:

Contract Number, order number, or identifier:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number and email address (PLEASE VERIFY):

Total dollar amount (receipts) for this effort during the past five (3) years broken into annual increments:

(For ordering vehicles, show both the annual estimated contract amount and the amount of orders actually performed):

(Show calendar year and dollars)

Number of personnel (FTE) performing per year (avg.):

Period of Performance:
From:

To:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the solicitation: (HINT: clearly demonstrate that the efforts performed in this reference are the same or similar to those set forth in Section C of the PWS in the solicitation)

Quality, delivery, or cost problem(s); corrective action(s) taken; and effectiveness of the corrective action(s):

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:

File details come from the government source that posted it. Updated .