Atch_4_-_PPI.pdf

RFQ No.: FA5270-17-Q-A009 Atch 4

Past/Present Performance Information (PPI)

Past/Present Performance Information Sheet

No. 1 -履歴1

i. Company/Division name 会社名/担当部署名(契約の相手方/注文主)

ii. Product/Service title and Description 業務内容

iii. Contracting Agency/Customer 契約事務所/顧客会社名

iv. Contract Number/Project Title 契約番号その他の認識番号/契約名

v. Contract Value/Amount (Per Year and/or Total) (Dollar/Japanese Yen) 単年度合計と契約金額合計

vi. Period of Performance (e.g. date/month/year through date/month/year) 契約期間 （自 至 ）

vii. Verified, up-to-date name, mailing and e-mail addresses, and telephone number of the contracting officer (Point-of-Contact) 契約担当者の氏名、役職、連絡先等。

例）米軍契約官、官公庁の契約担当者または技

術士など。

Name:

Tel:

Fax:

e-mail:

viii. Comments regarding compliance with contract terms and conditions 契約条件の遵守に関するコメント

ix. Comments regarding any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions 顧客に受け入れられなかった、または契約条件

に合わなかった業務に関するコメント

x. Contractor’s role. Work performed as:

契約者形態:

□Prime Contractor □Sub Contractor □Other (Explain)

Other Comments (optional) その他の特記事項

No. 2 -履歴2 contracting officer (Point-of-Contact) 契約担当者の氏名、役職、連絡先等。

例）米軍契約官、官公庁の契約担当者または技 e-mail:

viii. Comments regarding compliance with customer, or not in accordance with the contract terms and conditions

□Prime Contractor

No. 3 -履歴3 contracting officer (Point-of-Contact) 契約担当者の氏名、役職、連絡先等。

例）米軍契約官、官公庁の契約担当者または技 e-mail:

viii. Comments regarding compliance with customer, or not in accordance with the contract terms and conditions

□Prime Contractor