RFP,_Attch_8,_PP_Information.docx

PAST PERFORMANCE INFORMATION FORM

28 June 2017 A. Offeror Information:

Name (Company/Division):

CAGE Code: DUNS Number:

If Other than the Prime Offeror, Identify Prime Offeror:

B. Program Title:

C. Contract Specifics:

Contracting Agency or Customer:

Contract Number:

Contract Type: ______ Firm Fixed Price (FFP) Contract, ______FFP Task Order or Purchase Order, _____ Cost Reimbursable or Other Contractual Arrangement Period of Performance (include options):

Contract Dollar Value:

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

Yes or No Contract Environment: _______ Performance on an Air Force or Air Force Reserve Base, ____Performance on a DoD Installation within the United States _____ Performance at a Federal, State, County or City facility within the United States, ____ Other Performance Location.

D. Description of Contract as ___________ Prime or __________Subcontractor Indicate the type of services provided and highlight portions considered most relevant to the Base Custodial acquisition.

E. Size of Specialized Cleaning Facilities: Size of Child Development Center_____ SF, Size of Youth/School Age Center ____ SF, Size of Gymnasium____ SF

F. Number of building cleaned on a weekly basis: ____ NOTE! Buildings may only be counted once, even if they may be cleaned more than once on a weekly basis. For example, if building 595 is cleaned 3 times a week, it would still only be counted as 1 building.

G. 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.

Name:

Office:

Telephone Number: FAX Number:

Email Address: