Attachment 5 - Past Performace Info.pdf

PAST PERFORMANCE INFORMATION

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.

Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted to only relevant contracts/programs and the length of each submission to 2 pages per relevant contract/program.

A. Offeror Name (Company/Division): ____________________ CAGE Code: ____________________ DUNS Number: ____________________

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 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: Name ____________________ Office ____________________ Address ____________________

Telephone ____________________

2. Contracting Officer: Name ____________________ Office ____________________ Address ____________________ Telephone ____________________

3. Administrative Name ____________________ Contracting Officer Office ____________________ Address ____________________ Telephone ____________________

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

H. For each of the applicable subfactors under the Technical factor in Section M, illustrate how your experience on this program applies to that subfactor.

I. 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.

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).