Attachment_5_PPI.docx

Source Selection Information - See FAR 2.101 & 3.104. For Official Use Only OFFEROR’s NAME Past Performance Information Past Performance Factor

Contractor:

Contract Number:

Contract Type:

Program Title:

Short Title:

Cage Code:

Contracting Agency/Customer:

DUNS Number:

Delivery or Task Order:

Brief Description of Effort as: Prime, Sub, Joint Venture, or Other (explain)

Contract Dollar Value—Original: $ Current: $ Explain the differences in contract values, if applicable:

Period of Performance Start Date: Original End Date: Current End Date:

Explain the differences in Period of Performance, if applicable:

Recency:

Key Individuals:

Customer Points of Contact

Program Manager’s Name:

Office:

Address:

Telephone:

FAX:

Contracting Officer’s Name:

Office:

Address:

Telephone:

FAX:

Other POC Name and Position:

Office:

Address:

Telephone:

FAX:

Updated as of 23 May 2016 2