Attachment_L-1_PPIF.docx
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- Attached to
- Simplified Acquisition of Base Engineering Requirements (SABER) Federal contract opportunity
- Solicitation number
- FA9301-14-R-0011
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Past Performance Information Form
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ATTACHMENT L-1: PAST PERFORMANCE INFORMATION FORM
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 Section L-002 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, explain here: ______________________________________________________________________________ B. Program Title:_______________________________________________________________
C. Contract Specifics:
1. Contracting Agency or Customer:_________________________________________
2. Contract Number/Task Order/Job Order:____________________________________
| 3. Contract Type: | ☐ Fixed Price ☐ IDIQ | ||
| ☐ Cost | ☐ Others: (specify)____________________ |
4. Role: ☐ Prime ☐ Sub-contractor ☐ Mentor ☐ Protégé
5. SABER: ☐ Yes ☐ No
6. Job Disciplines:
☐ Heating Ventilation Air Conditioning (HVAC) ☐ Electrical (Indoor and Outdoor) ☐ Mechanical ☐ Design ☐ Carpentry ☐ Roofing ☐ Excavation ☐ Plumbing ☐ Sheet metal ☐ Painting ☐ Demolition ☐ Concrete masonry ☐ Welding ☐ Carpeting ☐ Lead abatement ☐ Asbestos abatement ☐ Steam Fitting ☐ Road and parking lot repair ☐ Fire Protection ☐ Fencing ☐ Other: _____________________________________________________________________
7. Contract Environment:
☐ USAF or Air Reserve Base (Conus) _________________________________
☐ DoD Installation_________________________________________________
☐ Federal ________________________________________________________
☐ State __________________________________________________________
☐ County____________________ State of______________________________
☐ City________________________________State of _______________________
☐ Other_____________________________________________________________
8. Period of Performance: From ______________________ To ___________________
9. Contract/Order/Project Amount: ___________________________________________
10. Highest amount of Task Orders performed concurrently under this contract:
11. Original Contract $ Value: $_____________________ (Do not include unexercised options)
12. Current Contract $ Value: $_____________________ (Do not include unexercised options)
13. If amounts for 11 and 12 above are different, provide a brief description of the reason:
D. Brief Description of Effort as _____ Prime or ____ Subcontractor or _____ Mentor or ______ Protégé (check one)
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 Name: _______________________________________________________
a. Office:________________________________________________________________
b. Address:________________________________________________________________
c. Phone:__________________________________________________________________
d. Email:__________________________________________________________________
2. Contracting Officer Name: _____________________________________________________
a. Office:__________________________________________________________________
b. Address:________________________________________________________________
c. Phone:__________________________________________________________________
d. Email:__________________________________________________________________
3. Administrative Contracting Officer Name: _______________________________________
a. Office:__________________________________________________________________
b. Address:________________________________________________________________
c. Phone:__________________________________________________________________
d. Email:__________________________________________________________________ G. Address any technical (or other) area about this contract/program considered unique:
H. Specify, by name, any key individual(s) who participated in this program and are proposed to support the instant acquisition. Also, indicate their contractual roles for both acquisitions.
FA9301-14-R-0011
Section L – Attachment L-1
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