Attachment_4_Performance_Information_Fact_Sheet.docx

Attachment 4

FA2823-15-R-3001

PERFORMANCE INFORMATION FACT SHEET

1. Offeror Information:

Name (Company/Division): ________________________________________________________________ CAGE Code: ____________________________________ DUNS Number: __________________________ If Other than the Prime Offeror, Identify Prime Offeror: __________________________________________

2. Program Title: ________________________________________________________________________

3. Contract Specifics:

Contracting Agency or Customer: ____________________________________________________________ Contract Number: ________________________________________________________________________ Contract Type (Firm-Fixed Price, Cost, etc.): ___________________________________________________ Period of Performance (include exercised options): ______________________________________________ Contract Dollar Value:

Has the contract been entered into the Contractor Performance Assessment Reporting System (CPARS)? _____Yes or ___No

4. Brief Description of Contract as ____________Prime or ____________Subcontractor Indicate the type of services provided and highlight portions considered most relevant to the PWS acquisition to include PWS paragraph citations.

Primary Customer Points of Contact:

For Government contracts, provide the following information for the Program Manager and Contracting Officer. For commercial contracts, provide equivalent to aforementioned Government positions. Ensure the individuals are currently available to provide past performance information if requested by the Government.

Contracting Officer: _______________________________________________________________ Telephone Number: _______________________________________________________________ Email Address: __________________________________________________________________ Program Manager: ________________________________________________________________ Telephone Number: _______________________________________________________________ Email Address: __________________________________________________________________ *****This document may extended to no more than 2-pages to accommodate any additional narrative for Paragraph 4. ******