Attachment 5 Past Performance Data Sheet Rev. 1A.docx
DOCX document 37 KB Posted
- Solicitation number
- HQ003426RE025
- Issued by
-
DOD Washington Headquarters Service
About this file
This is a Past Performance Data Sheet template for submission of past performance references in response to Solicitation Number HQ003426RE025 for Facility Environmental Compliance, Planning, and Resiliency Technical Support services. Offerors must complete the form without altering its spatial structure and are limited to two pages for Blocks 1 through 11 and two additional pages for Block 12.
The form requires offerors to provide comprehensive reference information including the complete name and address of the reference organization, contract number, contract dates, contract type with pricing details, final invoiced amount, and both technical and contracting points of contact. Offerors must identify the current contract status (ongoing, complete, terminated for convenience, terminated for default, or other) and provide a brief description of the contract work demonstrating its relevancy to the Performance Work Statement and solicitation requirements, including an estimated percentage of relevancy. Additional required information includes the location of work, whether the contract required a Small Business Subcontracting Plan under FAR 52.219-9, and if applicable, confirmation of timely SF 294/295 report submissions with a copy of the most recent submission. Block 14 requires a detailed summary of contract work not exceeding ten pages, describing the nature and scope of work, relevancy to the PWS sections, problems encountered and corrective actions, deliverables, and the extent of involvement as prime contractor, subcontractor, predecessor company, or key personnel.
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Text version
Source Selection Information - See FAR 2.101 and 3.104 ATTACHMENT - Solicitation Number HQ003425RE149
PAST PERFORMANCE DATA
(Note: Offerors must use this form, and are not to change the spatial structure of this form, i.e. borders, block size, etc.) (The page limit for Blocks 1 through 11 is two (2) pages) NOTE: Refer to Attachment 11 RFP Section M (V) Content Instructions (b).
Offeror’s Company Name:_______________________________________
1. Complete Name of Reference (Government agency, commercial firm, or other organization)
2. Complete Address of Reference
| 3. Contract Number or other control number |
| 4. Date of contract |
| 5. Date work was begun |
| 6. Date work was completed |
| 7. Contract type, initial contract price, estimated cost and fee, or target cost and profit or fee |
| 8. Final amount invoiced, or amount invoiced to date |
| 9a. Reference/Technical point of contact (name, title, address, telephone no. and email address) |
| 9b. Reference/Contracting point of contact (name, title, address, telephone no. and email address) |
10. Location of work (country, state or province, county, city)
11. Current status of contract (choose one): [ ] Ongoing [ ] Complete [ ] Terminated for Convenience [ ] Terminated for Default [ ] Other (explain)
12. Provide brief information describing the contract and the relevancy of the effort to be performed in accordance with the Performance Work Statement (PWS) and requirements of the solicitation. Provide an estimated % of relevancy of the referenced contract to the requirements set forth in this solicitation. Relevance shall address requirements included in the Facility Environmental Compliance, Planning, and Resiliency Technical Support PWS. Relevance can be discussed in further detail on the attached summary description as set forth in block 14 below. (The page limit for Block 12 is two (2) pages)
Source Selection information – See FAR 2.101 and 3.104 ATTACHMENT – Solicitation Number HQ003426RE025 Facility Environmental Compliance, Planning, and Resiliency Technical Support
13a. Did this contract require a Small Business Subcontracting Plan pursuant to FAR 52.219-9? Yes , No . 13b. If “Yes” to 13a, have you regularly submitted SF 294/295 reports on time? Yes , No .
13c. Attach a copy of your most recently submitted SF 294/295.
14. Provide a summary description of contract work, not to exceed ten (10) pages in length included in this form. Describe the nature and scope of work, its relevancy to this requirement’s performance work statement (PWS), include the PWS section(s), a description of any problems encountered and your corrective actions and any related deliverables. Include the extent of involvement (as a prime versus a subcontractor, predecessor company or key personnel).
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