Attachment_5 _Past_ _Present_Performance_Form.pdf

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Attached to
House Cleaning Services Federal contract opportunity
Solicitation number
FA5270-14-R-0001
Issued by
Department of the Air Force Pacific Air Forces

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Attachment 5 Past and Present Performance Form

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Attachment 5, PAST AND PRESENT PERFORMANCE FORM, June 2014

FA5270-14-R-0001

Type of Services

Customer/Address

Performance Period

Contract ¥/$ Amount

Point of Contact

Tel No.

Fax No.

Remarks

House Cleaning Services

XYZ Corporation 1-2-3 Yamauchi, Okinawa City, Okinawa

From: 1 Jan 2010 To: 31 Dec 2012

¥xxxxxxxxx Mr. A. Yamada 098-868-xxxx

098-868-xxx

House Cleaning Services

18th Contracting Office B-99, Kadena AFB, Okinawa, Japan

From: 1 Oct 2009 To: 30 Sep 2013

¥xxxxxxxxxx Mr. B. Contracting

098-961-xxxx

098-961-xxxx

COMPANY/OFFEROR’S NAME: ________________________________________________________________

POC’s Name, Title and Signature: _________________________________________________________________

Date: _______________________________

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