PP Information FINAL.doc

FA5000-12-R-0002

ATTACHMENT 5

PP INFORMATION

PAST PERFORMANCE INFORMATION

Provide the information requested in this form for each contract/program being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted.

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.

B.

Program Title: ____________________________________________________________________________ C.

Contract Specifics:

Contracting Agency or Customer: ____________________________________________________________ Contract Number: _____________________ Contract Type: ____________________________________ Period of Performance: Start Date: _______________________ End Date: _______________________

· Original Contract Value ($): ______________________ (Do not include unexercised options)

· Current Contract Value ($): ______________________ (Do not include unexercised options) If the above “ ( ” amounts are different, provide a brief description for the difference?

D.

Brief Description of Effort as ___ Prime or ___ Subcontractor:

E.

Completion Date:

Original Date: _____________________________ Current Schedule: ____________________________

Estimate at Completion: _____________________ How Many Times Changed: ____________________

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.

Program Manager and/or Site Manager:

Name: _________________________________ Office: ________________________________________ Address: __________________________________________ Telephone: _________________________ Address: __________________________________________ Fax Number: ________________________ Address: __________________________________________ Contracting Officer:

Name: _________________________________ Office: ________________________________________ Address: __________________________________________ Telephone: _________________________ Address: __________________________________________ Fax Number: ________________________ Administrative Contracting Officer:

Name: _________________________________ Office: ________________________________________ Address: __________________________________________ Telephone: _________________________ Address: __________________________________________ Fax Number: ________________________ Address: __________________________________________ G. Provide a narrative describing how this contract reference relates to the present acquisition in terms of relevancy.