Attachment 5 - GSM-ETI Past Performance Information.DOC

HC1028-10-R-2001

Attachment 5

PAST PERFORMANCE INFORMATION

Provide the information requested in this form for each contract/program (citation) 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 citations submitted and the length of each submission to the limitations set forth in Section L, paragraphs xxxx and xxx 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 procurement 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

4. Period of Performance

5. Initial Contract Cost/Price

6. Current/final Contract Cost/Price

7. Annual Contract $ Value __________________________

8. 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 procurement)

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:

3. COR:

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

H.

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

I.

Specify, by name, any key individuals who participated in this program and are proposed to support the procurement, and what their projected contractual role will be.

J. Include relevant information concerning your compliance with subcontracting plan goals for small disadvantaged business (SDB) concerns, monetary targets for SDB participation, and notifications submitted under FAR 52.219-25, Small Disadvantaged Business Participation Program—Disadvantaged Status and Reporting.

K.

Include relevant information concerning your compliance with FAR 52.219-8, Utilization of Small Business Concerns, on the contract you are submitting and the planned versus achieved goals during contract performance.

L. Identify past performance that was conducted a maximum of three years prior to issuance of the solicitation, or for ongoing efforts, must have been in place at least nine months before the proposal due date. (Recency) M. Identify past experience that provides sufficient evidence indicating how closely the services performed under those contracts relate to the technical/management subfactors and cost/price factors. More specifically, demonstrate the ability to perform complex installations from the planning stage to customer handoff and how the contractor managed multiple complex projects concurrently. (Relevance) N. Identify past performance of high capacity optical network solutions with a broad geographic CONUS and OCONUS scope, as related to the technical/management subfactors and cost/price factor