Section_L_Attachment_L2_-_Past_Performance_Information_Sheets.docx

DOCX document 22 KB Posted

Attached to
ENCORE III IT Services Federal contract opportunity
Solicitation number
HC1028-15-R-0030
Issued by
Defense Information Systems Agency

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Section L Attachment L2

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PAST PERFORMANCE INFORMATION SHEET

Provide the information requested in this form and the below summary for each contract reference. Provide frank, concise comments regarding your performance on the contracts you identify. Insert a new page break to separate the beginning of each new contract/program submitted. Limit the number of references submitted and the length of each submission to the limitations set forth at paragraphs 5.2 and 2.5.1, respectively, of Section L of this solicitation. Delete any unused references.

Summary for Past Performance Information Sheets

#
Program Name
Contract Number
Subfactor Reference*
Contract Type
Period of Performance
Dollar Value

*Reference related subfactor number from RFP Section M2 or M3. Enter N/A if not applicable.

Submittal Reference Number: 1

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. 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 (X one) (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 both individuals.)

1. Program Manager:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________
2. Contracting Officer:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________

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

[Insert Answer]

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.

[Insert Answer]

I. Describe the nature or portion of the work on the past performance reference 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).

[Insert Answer]

Submittal Reference Number: 2

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. 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 (X one) (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 both individuals.)

1. Program Manager:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________
2. Contracting Officer:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________

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

[Insert Answer]

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.

[Insert Answer]

I. Describe the nature or portion of the work on the past performance reference 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).

Submittal Reference Number: 3

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. 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 (X one) (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 both individuals.)

1. Program Manager:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________
2. Contracting Officer:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________

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

[Insert Answer]

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.

[Insert Answer]

I. Describe the nature or portion of the work on the past performance reference 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).

Submittal Reference Number: 4

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. 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 (X one) (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 both individuals.)

1. Program Manager:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________
2. Contracting Officer:Name:_________________________
Office:_________________________
Address:_________________________
_________________________
Telephone:_________________________

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

[Insert Answer]

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.

[Insert Answer]

I. Describe the nature or portion of the work on the past performance reference 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).

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