ATTACHMENT_J.3_Past_Performance_Information_Form.docx

SOLICITATION: EA133M18RP0026 ATTACHMENT: J.3

PAST

PERFORMANCE

INFORMATION

FORM

Form of

CONTRACT

NUMBER:

AGENCY

OR

CLIENT:

1. Refer to Section L of Solicitation EA133M18RP0026, Instructions to Offerors, REQUIREMENTS FOR PROPOSAL CONTENT.

** * The offeror shall complete this form in its entirety for each contract identified in the offeror’s Volume I – Past Performance Proposal.***

2. Check one of the following statements:

CPARS - The referenced Contract Number has a completed CPAR and can be located in the Past Performance Information Retrieval System (PPIRS).

Past Performance Questionnaire (Fill-in Data under item 3 prior to sending to Agency/Client POC)

The Point of Contact or Project Manager associated with the work completed under the referenced Contract Number has been sent this form and the Past Performance Questionnaire to complete and return to Contract Specialist, Michelle Blake, email michelle.blake@noaa.gov, prior to the closing date of the solicitation.

3. Provide the following data in its entirety.

b. Ship Name, Hull Number:

c. Dollar Value of the contract (Original: $ and Final: $ )

d. Type of service performed and whether Prime or Sub Contractor: Type: , Prime or Sub:

e. Contract performance period at the start of the contract: Start: End:

f. Actual performance dates upon completion: Begun: Completed:

g. Contract Type:

h. Percentage of growth in contract price (Additional work divided by award price) and the extent of Subcontracting:

Growth Percentage: % Extent of Subcontracting:

NOTE: IT IS THE RESPONSIBILITY OF THE OFFEROR TO FOLLOW-UP AND TO ENCOURAGE REFERENCES TO SUBMIT THE QUESTIONNAIRE PRIOR TO THE SOLICITATION CLOSING DATE.