Attachment_6_(Relevant_Experience_Worksheet).doc

DOC52PAPT1300018

Attachment “6”

Past Performance Reference Worksheet

1. Offeror:

5. Customer:

6. Title of Contract:

7. Contract Identifier:

8. Type of Contract

9. Contract Award Date:

10. Award Completion Date:

11. Actual Completion Date:

12. Award Value:

13. Actual Value:

Phone:

a. Contracting Officer:

b. Administrative Contracting Officer:

c. Contracting Officer's Technical Representative

d. Program Manager: (1)

Program Manager: (2)

Program Manager: (3)

15. Summary of Relevant Experience :

16. Any Significant Problems Encountered :

Instructions

Past Performance Reference Worksheet

1. Offeror: Name of the offeror submitting proposal

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

3. Role: Indicate PRIME or SUBCONTRACTOR to describe the role the Offeror played in this contract

4. 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

5. Title of Contract: May be system or project title

6. Contract Identifier: May be the number used to support billing

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

8. Contract Award Date: Date the contract was awarded

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

10. Actual Completion Date: Actual or currently anticipated completion date

11. Award Value: Value of this contract at time of award

12. Actual Value: Actual or currently anticipated value

13. 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

14. Summary of Relevant Experience: High-level description summarizing the relevant work performed by the offeror. In the summary, the offeror should show how the worked performed is relevant to the PTO’s requirements as specified in Section C of the RFP. (This section may expand to a second page).

15. Any 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.