Atch_1E_-_Past_Perf_Info_Sheet.docx
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- Solicitation number
- FA4600-13-R-0002
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Atch 1E Past Performance Information Sheet
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ADDENDA TO 52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL ITEMS
ATTACHMENT 1E: PAST PERFORMANCE INFORMATION SHEET
Provide the information requested in this form for each contract/program (citation) being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of citations submitted and the length of each submission to the limitations set forth at Table 2.0, of “Instructions to Offerors” for this solicitation.
| A. | Offeror Name (Company/Division): | ____________________ | ||
| CAGE Code: | ____________________ | |||
| DUNS Number: | ____________________ |
(NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume.)
| B. | Program Title: | ____________________ | ||
| C. | Contract Specifics: | ____________________ | ||
| 1. Contracting Agency or Customer | _____________________ | |||
| 2. Contract Number | _____________________ | |||
| 3. Contract Type | _____________________ | |||
| 4. Period of Performance | _____________________ | |||
| 5. Initial Contract Cost/Price | _____________________ | |||
| 6. Current/final Contract Cost/Price | _____________________ | |||
| 7. Annual Contract $ Value | _____________________ |
8. If Amounts for 5 and 6 above are different, provide a brief description of the reason ____________________________________________________________________________________________________________________________________________________________________________________________________ D. Brief Description of Effort as __Prime or __Subcontractor (Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition)
| E. | Completion Date: | |||
| 1. Original date: | ____________________ | |||
| 2. Current Schedule: | ____________________ | |||
| 3. Estimate at Completion: | ____________________ | |||
| 4. How Many Times Changed: | ____________________ | |||
| 5. Primary Causes of Change | _______________________________________ |
| F. | Primary Customer Points of Contact: (For Government contracts, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.) | |||||
| 1. Program Manager: | Name | ____________________ | ||||
| Office | ____________________ | |||||
| Address | ____________________ | |||||
| ____________________ | ||||||
| Telephone | ____________________ | |||||
| 2. Contracting Officer: | Name | ____________________ | ||||
| Office | ____________________ | |||||
| Address | ____________________ | |||||
| ____________________ | ||||||
| Telephone | ____________________ | |||||
| 3. Administrative | Name | ____________________ | ||||
| Contracting Officer | Office | ____________________ | ||||
| Address | ____________________ | |||||
| ____________________ | ||||||
| Telephone | ____________________ | |||||
| G. | Address any technical (or other) area about this contract/program considered unique. | |||||
| H. | For each of the applicable Factors and Subfactors in the 52.212-2 Evaluation Factors for Award, Section M3.1, illustrate how your experience on this program applies to that Factor and Subfactor. | |||||
| I. | Specify, by name, any key individual(s) who participated in this program and are proposed to support the instant acquisition. Also, indicate their contractual roles for both acquisitions. | |||||
| J. Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported here. Also, estimate the percentage of the total proposed effort to be performed by this entity and whether this entity will be performing as the prime, subcontractor, or a corporate division related to the prime (define relationship). | FA4600-13-R-0002, Attachment 1E, Pages 2 |
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