Attachment_15_(Experience_Reference_Worksheet).doc

DOC52PAPT1300014

Attachment 15

Experience Reference Worksheet

5. Customer:

6. Title of Contract:

7. Contract Identifier:

8. Type of Contract

9. Contract Award Date:

11. Actual Completion Date:

10. Award Completion Date:

12. Award Value:

13. Actual Value:

Phone:

a. Contracting Officer:

b. Administrative Contracting Officer:

c. Contracting Officer's Representative

d. Program Manager: (1)

Program Manager: (2)

Program Manager: (3)

15. Abstract:

Instructions

Past Performance Reference Worksheet

1.

Offeror: Name of the offeror submitting proposal

2.

Prime Name: Name of the organization that did the work (Must be the Prime prosing)

3.

DUNS #: DUNS identifier for the organization identified in 2. above

4.

Role: Indicate PRIME or SUBCONTRACTOR to describe the role the organization identified in 2. above played in this contract

5.

Customer: Agency or commercial organization that this work was performed for. If the role was a subcontractor, do not place the Prime’s name here, but rather the Prime’s customer

6.

Title of Contract: May be system or project title

7.

Contract Identifier: May be the number used to support billing

8.

Type of Contract: Example: cost plus fixed fee, fixed price

9.

Contract Award Date: Date the contract was awarded

10.

Award Completion Date: At the time of contract award, what was the projected completion date

11.

Actual Completion Date: Actual or currently anticipated completion date

12.

Award Value: Value of this contract at time of award

13.

Actual Value: Actual or currently anticipated value

14.

This section calls for the names and telephone numbers for the following:

a.

Contracting Officer: Government or Commercial procuring contracting officer for this activity b.

Administrative Contracting Officer: May be the same as the Contacting Officer c.

Contracting Officer’s Technical Representative: Government or Commercial contract activity technical representative d.

Program Manager: Government or Commercial customer’s program manager; there may be more than one

15.

Abstract: High-level description or abstract summarizing the work performed by the organization identified in 2. Prime Name. In the abstract, the offeror should show how the worked performed by the organization is relevant to the PTO’s requirements as specified in Section C.3 of the RFP. (This section may expand to a second page).

16.

Significant Problems: If the offeror anticipates that references will identify significant problems that arose during this project, the offeror may provide an assessment of the nature of the problem (normal, usual, or extraordinary), how and when the problem was identified, potential causes, resolution activities or corrective actions undertaken, and the results of the corrective actions. Offerors shall not provide general information on their performance.