Attachment_6A_-_Past_Performance_Information_Brief.pdf

DJM-17-A32-R-0006

X-Ray Screening Equipment

Attachment 6(A) Past Performance Information Brief

1) Offeror Information:

Company Name

Street Address

City State Zip Code

DUNS Number CAGE Code

Company POC

Phone Number Email Address

2) Contracting Activity/Organization Information: (Recipient of Past Performance)

Entity Name

Street Address

City State Zip Code

3) Contract Information:

Contract Number NAICS Code (If Applicable)

Status Active

Completed

Total Contract Value (Base + Option Years)

Award Date Period of Performance to

Original Estimated Completion Date Actual Completion Date

Reason for Schedule Variance

(if applicable)

Contract Method and Type of Contract

Commercial Performance Based Requirements

FAR 15 Negotiated Blanket Ordering Agmt. ID/IQ

Labor Hour Time & Material Competitive

Non-Competitive Set-Aside Small Business / 8(a)

Sm Biz Innovation Rsrch. Fixed Price (FP) FP Incentive

FP Economic Price Adj. Award Fee Cost Reimbursement

Cost + Fixed Fee Cost + Incentive Fee Cost + Award Fee

Other

Nature and Scope of the Work:

4) Evaluator Information (Provide Applicable):

Contracting Officer

(CO)

Phone Number Email Address

Administrative CO

Phone Number Email Address

Program Manager:

Phone Number Email Address

Contracting Officer's Representative (COR)

Phone Number Email Address

5) Other Information:

Additional Information