Atch2-PPIList-Call_Center.doc

Solicitation No. FA5209-16-T-0058 Attachment 2

PRESENT/PAST PERFORMANCE REFERENCE LIST履行履歴表

CALL CENTER APPOINTMENT LINE CLERK FOR 374TH MEDICAL GROUP

1. Name of Contracting Activity

契約の相手方/注文主

2. Name and title of point of contact (POC); Contracting Officer or/and Government Inspector/commercial project manager’s phone/Fax number, and e-mail address 契約担当者の氏名、役職と連絡先 例）米軍契約官または検査官、官公庁の 契約担当者または技師長など。

Tel:

Fax:

e-mail:

Tel:

Fax:

e-mail:

Tel:

Fax:

e-mail:

3. Contract number and project title

契約番号その他の識別番号

4. Total contract value

単年度合計と契約金額合計

5. Performance period

(e.g. date/month/year through date/month/year)

契約期間 （自 至 ）

6. Description of contract work performed

主な業務の内容

7. Contractor’s contract manager or supervisory technicians

請負業者の責任者または技師長

8. Comments (optional)

その他の特記事項

Name of Offeror (入札者御社名) : ____________________________________