Attachment_5_Past_and_Present_Performance_Information_Document.doc

Source Selection Information (FAR 2.101 and 3.104)

H92222-13-R-0013 Attachment 5

Past and Present Performance Information Document Complete this form for each contract/program submitted for evaluation.

Provide frank, concise comments regarding your performance on the contracts you identify.

1. Contract Title: ____________________________________________

2. Contract Number:__________________________________________

3. Contractor Name:__________________________________________ Address:__________________________________________

Phone:__________________________________________

E-mail:__________________________________________

4. Contractor’s DUNS Number:_________________ and CAGE Code:__________

5. Contractor type: Please check one box from each column.

___Firm-Fixed Price

___Independent Contract

___Cost Plus Fixed Fee

___IDIQ Contract Task Orders

___Cost Plus Award Fee

___Time and Materials

___Labor Hour – Level of Effort

6. Excluding unexercised options:

Original Contract Value: _____________ Current Value: _____________

7. Original Period of Performance:

Start: __________ End:__________

8. Place of performance (check all that apply):

___Single Location

___Multiple Locations

___CONUS

___OCONUS – Specify Country(s): ______________________________

9. Describe the nature or portion of work performed by this company.

9a. Was this work performed as a prime, subcontractor, corporate division related to the prime, or team/joint venture partner? _______________________________________________________

9b. What was the percentage of work performed by this company? ________________________

9c. If you performed as a Subcontract, Team Partner, or Joint Venture Partner: Provide Prime Contractor’s Name: ___________________________________

Address: ___________________________________

Phone: ___________________________________

E-mail: ___________________________________

10. Contracting Agency or Customer: _____________________________

11. Reference contact information: Provide two (2) points of contact most knowledgeable of the submitted contract. For Government contracts, points of contacts my include Program Manager, Project/Task Manager, Contracting Officer, and Administrative Contracting Office. For commercial contracts, provide two (2) points of contract fulfilling these same roles.

Name

Position Organization Phone

E-mail

12. Provide a brief description of services provided under this contract. Include details that will indicate specific relevant personnel (i.e., Program Manager, SMEs etc.). Identify problems encountered and effort taken to resolve problems, as well as efforts to identify and manage program risks. Clearly demonstrate management actions employed in overcoming problems and the effects of those actions in terms of improvements achieved or problems solved.

13. Describe in detail how your experience on this program applies to the Relevancy Criteria identified in Section M. Clearly link the past performance information to the current efforts Performance Work Statement (PWS).

Source Selection Information (FAR 2.101 and 3.104)

H92222-13-R-0013 Attachment 6