Attachment_1.1_Past_Performance_Information_Form.docx

ITO ATTACHMENT 1.1

PAST PERFORMANCE INFORMATION FORM

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

A. Offerer Name (Company/Division):

CAGE CODE:

DUNS NUMBER:

(NOTE: If the company or division performing this effort is different than the offerer 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:

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:

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 (Include performance considered most relevant to current acquisition)

E. Are there Contractor Performance Assessment Reports (CPARS) or other Past Performance Reports available for this contract? YES NO

F. Primary Customer Points of Contact: (For Government contracts provide current information on all individuals. For commercial contracts, provide points of contact fulfilling these same roles)

1. Program Manager, COR and/or Site Manager Name: Telephone: Email:

2. Contracting Officer Name: Telephone: Email:

FA810119RA010 52.212-1 ADDENDUM

INSTRUCTIONS TO OFFERORS (ITO)

G. Address any technical (or other) area about this contract considered unique.

H. For each applicable technical factor, illustrate how your experience on this contract applies, if you are to perform the same effort on the proposed contract.

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

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).