Attachment_B_-_Reference_Information_Sheet.pdf

Attachment B – Reference Information Sheet

RFQ – G15PS00321

Reference Information Sheet – Summary Data

Contractor Name: __________________________________________

Cage Code: __________________________________________

Address: __________________________________________

Point of Contact: __________________________________________

Telephone Number: __________________________________________

Fax Number: __________________________________________

Email Address: __________________________________________

Contract Number: Performed Work As: Method for Obtaining Past

Performance*:

__ Prime or __ Subcontractor __ CPARS __ Questionnaire

__ Prime or __ Subcontractor __ CPARS __ Questionnaire

__ Prime or __ Subcontractor __ CPARS __ Questionnaire

Attachment B

RFQ –G15PS00321

Reference Information Sheet – Summary Data

(Duplicate this form as needed for each contract reference cited above)

1. Contract Number: ________________________________________________________

2. Complete Name and Address of Contract Reference (agency, firm, or organization):

3. Date of Contract Award: ___________________________________________________

4. Date Work Began Under Contract: ___________________________________________

5. Date Work Was Completed: ________________________________________________

6. Contract Type: ___________________________________________________________

7. Initial Contract Ceiling: ____________________________________________________

8. Final or Current Contract Ceiling: ____________________________________________

9. Final Invoiced Amount or Amount Invoiced to Date: _____________________________

10. Technical Point of Contact for Reference: ______________________________________

11. Contracting Point of Contact for Reference: ____________________________________

12. Current Status of Contract: _________________________________________________

13. Provide summary description of contract work, not to exceed 2 pages in length.