Attachment_5,_Past_&_Present_Performance_Form.pdf
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- FA5270-17-Q-0011
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Past and Present Performance Form
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PAST AND PRESENT PERFORMANCE FORM (Attachment 5)
FA5270-17-Q-0011
Type of
Services
Customer/Address
Performance
Period
Contract
¥/$ Amount
Point of Contact
Tel No.
Fax No.
Remarks
Wastewater
Treatment
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
Wastewater
Treatment
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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