PPIS.doc

PAST AND PRESENT PERFORMANCE INFORMATION SHEET (PPIS)

Provide the information requested in this form for each contract/program being described. Provide frank, concise comments regarding your performance on the contracts you identify. Request each Offeror submit up to 5 PPIS forms for the prime Contractor and each significant subcontractor/teaming partner.

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. Title:

C. Contract Specifics:

1. Contracting Agency or Customer:

2. Contract Number:

3. Contract Type:

(If multiple types (i.e. Firm-Fixed Price with Time & Material), list percentage and dollar amount of Firm-Fixed Price portion)

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

E. Completion Date:

1. Original date:

2. Current Schedule:

3. Estimate at Completion:

4. How Many Times Changed:

5. Primary Causes of Change:

F. Is there past performance information available for this contract in the Construction Contractor Appraisal Support System (CCASS) or other Past Performance Reporting systems?

YES __

NO

G.

Primary Customer POC: (For Government contracts provide current information on all three individuals. For construction contracts, provide POC fulfilling these same roles).

1. Program Manager and/or Name:

Site Manager Office:

Address:

Telephone:

Fax Number:

Email:___________________________________________________

2. Contracting Officer

3. Administrative

Contracting Officer

H. Address any technical (or other) area about this contract/program considered unique.

I. For the applicable technical factor in the “Evaluation Criteria for Award, illustrate how your experience on this program applies, if you are to perform the same effort on the proposed contract.

J. Specify, by name, any key individual(s) who participated in this evaluated program and are to support the proposed effort. Also, indicate their contractual roles for both acquisitions.

K. 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).