Attachment 11 - Past Performance Data Worksheet - Aircraft Charter Services.doc

ATTACHMENT #11 –PAST PERFORMANCE DATA WORKSHEET – RFQ # DJMS-10-Q-0242

1.

Name of Contracting Activity/Organization:

2.

Contract Number: _______________________________________________________ 3.

Contract Type: Negotiated_________________ Sealed Bid ________________

Labor Hour (IDIQ) ________________Cost Reimbursement ________________

Firm Fixed Price_______________________ Other_______________________ 4.

Total Contract Value: $___________________________________________________ 5.

Status: Active_____________________ Completed______________________ 6.

Date of Award: ___________________________________________________

Original estimated completion date: ___________________________________

Actual completion date: _________________________________________________

Explanation for variance: _________________________________________________ 7.

Nature and Scope of the work: ____________________________________________

8.

Contracting Officer and Telephone Number: ________________________________ 9.

Program Manager and Telephone Number: _________________________________ 10.

Administrative Contracting Officer (if different from #8):

11.

Contracting Officer’s Technical Representative (COTR) and Telephone Number:

12.

COTR’s E-mail Address:

13.

List of major subcontracts and their contribution to the overall value of the contract (percentage):

14.

Any problems or mitigating circumstances which the offeror would like to have known to balance the evaluations of those named above:

A SEPARATE WORKSHEET MUST BE COMPLETED FOR THREE (3) GOVERNMENT OR COMMERCIAL CONTRACTS PERFORMED DURING THE LAST 3 YEARS THAT ARE SIMILAR AND RELEVANT TO THE PERFORMANCE REQUIREMENTS IN THE SOLICITATION.

-USE ADDITIONAL PAPER IF NECESSARY-