14-R-0001-Atch3-PPID.pdf

FA5613-14-R-0001

Attachment 3

For Official Use Only

PAST PERFORMANCE INFORMATION DOCUMENT (PPID)

Provide the information requested in this form for each contract being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract submitted. Limit the number of past efforts submitted to the limitations set forth in the Addendum to FAR 52.212-1, paragraph (b)(10)(i) of this solicitation.

A. Offeror Name (Company/Division): _________________________________

CAGE Code: _________________________________

DUNS Number: _________________________________

(NOTE: If the company or division performing this effort is different than the offeror, or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, please note those changes accordingly.)

B. PROGRAM TITLE: ____________________________________________________________

C. CONTRACT SPECIFICS

1. Contracting Agency or Customer: ______________________________

2. POC Name, valid phone number and email address: _________________________________

3. Contract Number: _________________________________

4. Contract Type: _________________________________

5. Brief Description of Work:

6. Period of Performance: _________________________________ (Note option years, if appliable)

7. Original Contract $ Value: _________________________________ (including all option years, if applicable)

8. Current Contract $ Value: _________________________________ (including all option years, if applicable)

9. If Amounts for 7 and 8 above are different, provide a brief description of the reason:

FA5613-14-R-0001

Attachment 3

For Official Use Only

D. BRIEF DESCRIPTION OF EFFORTS AS PRIME OR SUBCONTRACTOR: (Please highlight portions considered most relevant to the current acquisition. Discuss efforts/management actions accomplished to successfully overcome and resolve any problems encountered.)

E. COMPLETION DATE:

1. Original Date: _________________________________

2. Current Schedule: _________________________________

3. Estimated at Completion: _________________________________

4. How Many Times Changed: _________________________________

5. Primary Causes of Change:

F. Specify, by name, any key individual(s) who participated in this contract and are proposed to support the instant acquisition. Also, indicate their contractual roles for both acquisitions.

G. Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported here. Also, estimate the percentage of the total proposed effort to be performed by this entity and whether this entity will be performing as the prime, subcontractor, or a corporate division related to the prime (define relationship)