5_Atch_3_-_PPI.docx

Attachment 3 - Past Performance Information (PPI) Template Solicitation No: FA5209-19-U-0022

PRESENT/PAST PERFORMANCE INFORMAITON

INFECTION PREVENTIONIST SERVICES FOR 374 MDGYOKOTA AIR BASE, JAPAN

1. Name of contracting activity

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

Tel:

e-mail:

3. Contract number and project title

4. Contract Type (e.g. Firm-Fixed Price, IDIQ, Requirements type)

5. Total contract value ($)

6. Performance period (e.g. date/month/year through date/month/year)

7. Description of contract work performed

8. Contracting Officer’s name and phone number

9. Government Inspector/commercial project manager and phone number

10. List of major subcontractors if applicable

COMPANY NAME:________________________________________________