Atch_2_-_Past_Performance_Information_(PPI).pdf

RFQ No.: FA527019QA007 Atch 2

Past/Present Performance Information (PPI)

Name of Quoter:____________________________________________

The following Three (3) contracts are the most relevant contracts (similar in scope, magnitude (size) and complexity) performed for US Government agencies, Government of Japan, and Commercial customers performed within the last 3 years of the solicitation release date, or is currently in progress (see Solicitation Provision 52.212-1). Limited to no more than three(3) pages per contract listed.

今現在、または過去 3 年以内に、請け負った同種、同規模の契約の情報をご記入ください。

*民間会社との契約の場合は、３-4 を除く１－12 までを記入。 **アメリカ政府または日本政府、県、地方自治体などとの契約の場合は、1 を除く、2-12 までを記入。

Past/Present Performance Information Sheet

Reference 1 –照会先1

1. Company/Division name 会社名/担当部署名

2. Product/Service title and Description

業務内容

3. Contracting Agency/Customer

契約事務所/契約政府機関（地方自治体を含む）

4. Contract Number/Project Title

契約番号その他の番号/契約名

5. Contract Value/Amount (Per Year and/or

Total) (Dollar/Japanese Yen) 一年ごとの 契約金額と契約金額合計

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

7. Verified, up-to-date name, mailing and e- Name:

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 Tel:

術士など。 Fax:

e-mail:

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

9. Comments regarding any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions 相手先に受け入れてもらえなかった、業務内容等があ れば、その旨を記入してください。

10. Include rationale supporting your assertion of relevance and identify aspects (scope, magnitude of effort, and complexity) of the contracts deemed relevant and how they relate to the proposed effort.

この業務を請け負ったなかで、今回の案件とどのような関 連性のある業務内容(契約の範囲、規模、複雑さ)をもっ ているか。

11. Contractor’s role. Work performed as:

契約者形態:

□Prime Contractor □Sub Contractor □Other (Explain)

12. Other Comments (optional) その他の特記事項

Please note, the Japanese translation used in this document is only applied for your reference. In the event of inconsistency between English version and Japanese Translation, the English language meaning shall control.

この書類に使われた日本語訳はあくまでも参考までの表記です。英語と日本語訳とのあいだに矛盾が生じた場合、英語版が優先されます。

Reference 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 Tel:

術士など。 Fax:

e-mail:

8. Comments regarding compliance with accordance with the contract terms and conditions of relevance and identify aspects (scope, magnitude of effort, and complexity) of the contracts deemed relevant and how they relate to the proposed effort.

この業務を請け負ったなかで、今回の案件とどのような関

契約者形態:

□Prime Contractor □Sub Contractor □Other (Explain)

Please note, the Japanese translation used in this document is only applied for your reference. In the event of inconsistency between English version and Japanese Translation, the English language meaning shall control.

Reference 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 Tel:

術士など。 Fax:

e-mail:

8. Comments regarding compliance with accordance with the contract terms and conditions of relevance and identify aspects (scope, magnitude of effort, and complexity) of the contracts deemed relevant and how they relate to the proposed effort.

この業務を請け負ったなかで、今回の案件とどのような関

契約者形態:

□Prime Contractor □Sub Contractor □Other (Explain)

Please note, the Japanese translation used in this document is only applied for your reference. In the event of inconsistency between English version and Japanese Translation, the English language meaning shall control.