ATTACHMENT_5__Past_Performance_Reference_Information_Form.pdf

PDF 774 KB Posted

Attached to
Integrated Pest Management Program Federal contract opportunity
Solicitation number
HDEC05-19-R-0002
Issued by
Defense Commissary Agency

About this file

Attachment 5 Past Performance Reference Information Form

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Text version

Offeror Company Name

Offeror POC

POC Phone

POC Email

Name:

Address:

Name:

Phone:

Email:

Name:

Phone:

Email:

Contracting Manager or Contracting Officer Representative (COR)

Contract Number or Account Number:

Description of Work Performed

Total Value (including all option years)

Type (FFP, Cost Reimbursement, IDIQ, etc.)

ATTACHMENT 5

SOLICITATION HDEC05-19-R-0002

Past Performance Reference Information Form Completed form must be emailed no later than

April 16, 2019 Send To: barbara.desrochers@deca.mil and daniel.lindsey@deca.mil

Reference No. 1

Contracting Agency or Commercial Company

Contracting Officer or Commercial Agent's

Performance Period (Dates that Review Covers) Base year and number of option years

Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken on all contracts. Include a brief description of any dispute/ claim.

POC Phone

POC Email

Name:

Address:

Name:

Phone:

Email:

Name:

Phone:

Email:

Contracting Manager or Contracting Officer Representative (COR)

Contract Number or Account Number:

Description of Work Performed

Total Value (including all option years)

Type (FFP, Cost Reimbursement, IDIQ, etc.)

ATTACHMENT 5

SOLICITATION HDEC05-19-R-0002

Past Performance Reference Information Form Completed form must be emailed no later than

April 16, 2019 Send To: barbara.desrochers@deca.mil and daniel.lindsey@deca.mil

Reference No 2

Contracting Agency or Commercial Company

Contracting Officer or Commercial Agent's

Performance Period (Dates that Review Covers) Base year and number of option years

Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken

POC Phone

POC Email

Name:

Address:

Name:

Phone:

Email:

Name:

Phone:

Email:

Contracting Manager or Contracting Officer Representative (COR)

Contract Number or Account Number:

Description of Work Performed

Total Value (including all option years)

Type (FFP, Cost Reimbursement, IDIQ, etc.)

ATTACHMENT 5

SOLICITATION HDEC05-19-R-0002

Past Performance Reference Information Form Completed form must be emailed no later than

April 16, 2019 Send To: barbara.desrochers@deca.mil and daniel.lindsey@deca.mil

Reference No. 3

Contracting Agency or Commercial Company

Contracting Officer or Commercial Agent's

Performance Period (Dates that Review Covers) Base year and number of option years

Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken

POC Phone

POC Email

Name:

Address:

Name:

Phone:

Email:

Name:

Phone:

Email:

Contracting Manager or Contracting Officer Representative (COR)

Contract Number or Account Number:

Description of Work Performed

Total Value (including all option years)

Type (FFP, Cost Reimbursement, IDIQ, etc.)

ATTACHMENT 5

SOLICITATION HDEC05-19-R-0002

Past Performance Reference Information Form Completed form must be emailed no later than

April 16, 2019 Send To: barbara.desrochers@deca.mil and daniel.lindsey@deca.mil

Reference No. 4

Contracting Agency or Commercial Company

Contracting Officer or Commercial Agent's

Performance Period (Dates that Review Covers) Base year and number of option years

Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken

POC Phone

POC Email

Name:

Address:

Name:

Phone:

Email:

Name:

Phone:

Email:

Contracting Manager or Contracting Officer Representative (COR)

Contract Number or Account Number:

Description of Work Performed

Total Value (including all option years)

Type (FFP, Cost Reimbursement, IDIQ, etc.)

ATTACHMENT 5

SOLICITATION HDEC05-19-R-0002

Past Performance Reference Information Form Completed form must be emailed no later than

April 16, 2019 Send To: barbara.desrochers@deca.mil and daniel.lindsey@deca.mil

Reference No. 5

Contracting Agency or Commercial Company

Contracting Officer or Commercial Agent's

Performance Period (Dates that Review Covers) Base year and number of option years

Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken

Attachment 5 Past Performance Reference Form Reference 1.pdf

Offeror Company Name:
Offeror POC:
POC Phone:
POC Email:
Agency or Company:
Address:
Name of Contracting Officer:
Phone:
Email:
Contracting Mgr Name:
Phone_2:
Email Address:
Contract Number or Account Number:
Description of Work Performed:
Contract Type:
Total Value including all option years:
Performance Period:
ProblemsCorrective Actions TakenOutcome:

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