FA805121R3010 Attachment 4 PPI submission form.docx
DOCX document 22 KB Posted
- Attached to
- Rapid Explosive Hazard Mitigation (REHM) Large Clearance Blade Assembly (L-CBA) Federal contract opportunity
- Solicitation number
- FA805121R3010
About this file
This document contains a pre-solicitation notice and past performance information submission form related to a requirements contract for Rapid Explosive Hazard Mitigation Large Clearance Blade Assemblies. The Air Force seeks to award a five-year indefinite delivery/indefinite quantity contract with a $24 million ceiling to procure approximately 100 blast-resistant blade assemblies to clear unexploded ordnance from airfields. Responses are due approximately 30 days after a formal solicitation is posted to SAM.gov on or around July 30, 2021. The competition is set aside for small businesses in NAICS code 333120 with a size standard of 1,250 employees. The submission form requests past performance and organizational information from offerors to evaluate experience in areas such as technical design, manufacturing, and small business utilization relevant to the requirement.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FA805121R3010 Attachment 2 Combined LCBA Design Specifications - 20210511.pdf | ||
| FA805121R3010 Attachment 1 LCBA SOW 20 July 2021.docx | DOCX document | |
| Solicitation - FA805121R3010.pdf | ||
| FA805121R3010 Attachment 5 Subcontractor Consent form.docx | DOCX document | |
| FA805121R3010 Attachment 3 LCBA CLIN Price Sheet.xlsx | XLSX spreadsheet | |
| FA805121R3010 - L-CBA SOW - Final (30 June 21).docx | DOCX document | |
| Combined LCBA Design Specifications - 20210511.pdf |
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Text version
FA8051-21-R-3010 ATTACHMENT #4
PAST PERFORMANCE INFORMATION
Provide the information requested in this form for each contract/program (citation) being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of citations submitted and the length of each submission to the limitations set forth at paragraphs (II)(D)(2) and (II)(A), respectively, in Section L 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, note those changes. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume).
| B. | Program Title: ____________________ |
| C. | Contract Specifics: |
| 1. Contracting Agency or Customer _____________________________________________ | |
| 2. Contract Number__________________________________________________________ | |
| 3. Contract Type __________________________ | |
| 4. Period of Performance __________________________ | |
| 5. Original Contract $ Value _________________ (Do not include unexercised options) | |
| 6. Current Contract $ Value _________________ (Do not include unexercised options) | |
| 7. If Amounts for 5 and 6 above are different, provide a brief description of the reason ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ | |
| D. | Brief Description of Effort as __Prime or __Subcontractor |
(Please indicate whether it was development and/or production, or other acquisition phase (or Service) and highlight portions considered most relevant to current acquisition)
E. Completion Date:
| 1. Original date: | ____________________ |
| 2. Current Schedule: ____________________ | |
| 3. Estimate at Completion: ____________________ | |
| 4. How Many Times Changed: ____________________ | |
| 5. Primary Causes of Change: _______________________________________________________ |
F. Primary Customer Points of Contact: (For Government contracts provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles).
1. Program Manager and/or Site Manager:
| Name | ____________________ | |
| Office | ____________________ | |
| Address________________________________________ | ||
| Telephone__________________ | ||
| FAX Number_______________ |
2. Contracting Officer:
| Name | ____________________ | |
| Office | ____________________ | |
| Address________________________________________ | ||
| Telephone__________________ | ||
| FAX Number_______________ |
3. Administrative Contracting Officer:
Name ____________________ Office ____________________ Address________________________________________
| Telephone__________________ |
| FAX Number_______________ |
G. Address any technical (or other) area about this contract/program considered unique.
H. For each of the applicable sub-factors under the Technical factor in Section M, illustrate how your experience on this program applies to that sub-factor.
| I. | Include relevant information concerning your compliance with FAR 52.219-8, Utilization of Small Business Concerns, on the contract you are submitting. |
| J. | 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). |
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