Atch3-PP_List_of_References.pdf

Attachment 3-List of References Solicitation #: FA3010-18-R-0025

3 FTE Disability Eval Sys Prgm Specialist

PAST PERFORMANCE LIST OF REFERENCES

Company Name:________________________________

CONTRACT NUMBER

(include task order number(s) if applicable) Identify if CPAR is available.

If so, no PPQ is required.

DESCRIPTION OF WORK PERFORMED

(performed as a prime/sub-contractor, details i.e.

number of FTE, position type, full-time or session-based, %performed, etc. )

CONTRACT

PERIOD OF

PERFORMANCE

(POP)

CONTRACTING AGENCY

POC/CUSTOMER NAME, PHONE #

& EMAIL

CONTRACT VALUES

(include total contract amount, annual amount and POP for annual amount)

PERFORMED BY A

PROPOSED

SUBCONTRACTOR

AFFILIATE, OR

JOINT VENTURE?

(If yes, please complete Page 2)

Total: $

Annual: $

POP for Annual:

Attachment 3-List of References Solicitation #: FA3010-18-R-0025

3 FTE Disability Eval Sys Prgm Specialist

CONTRACT NUMBER

(include task order number(s) if applicable)

SUBCONTRACTOR,

AFFILIATE, OR

JOINT VENTURE

DESCRIBE FUNCTION/TASK/3RD PARTY AFFECT ON PERFORMANCE

1. If proposing to use a Subcontractor, Affiliate, or Joint Venture for this effort, include percentage of work, splitting of cost, type of services i.e. accounting, recruiting, etc they will perform for this effort (provide information below)

2. If contractor proposing on this effort provided past performance they performed as a Subcontractor, Affiliate, or Joint Venture, include percentage of work, splitting of cost, type of services performed, i.e. accounting, recruiting, etc for that effort (provide information below)

1.

2.