Attachment 6 - Past Performance Information.pdf

Source Selection Sensitive Information IAW FAR 2.101 and FAR 3.104

RFQ: FA483025Q0027

Title: Local Telecommunication Services

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PAST PERFORMANCE INFORMATION FORM

April 2025

A. Offeror Information:

Name (Company/Division):

CAGE Code: UEI 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 _______ Performance at a Federal, State, County or City facility _______ 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 CATM Range Maintenance acquisition.

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Source Selection Sensitive Information IAW FAR 2.101 and FAR

3.104 RFQ: FA483025Q0027

Title: Local Telecommunication Services

E. 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 Government positions listed). Ensure the individuals are currently available to provide past performance information if requested by the Government.

Name:

Office:

Telephone Number: FAX Number:

Email Address:

FA483025Q0018