Att_3_-_Past_Performance_Information_Questionnaire.pdf

PRESENT AND PAST PERFORMANCE

INFORMATION QUESTIONNAIRE

Attachment 3

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. Task Order Number (if applicable)

5. Period of Performance Start Date

6. Period of Performance End Date

7. Contract type (Cost, Cost-Sharing, CPFF, CPIF, CPAF, FFP, FP-EPA, FPIF, T&M, Labor Hour)

8a. Initial Contract Value:

8b. Current Contract Value:

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): [ ] Work completed, claims negotiations pending or underway

[ ] Work continuing, on schedule [ ] Work completed, litigation pending or underway

[ ] Work continuing, behind schedule [ ] Terminated for Convenience [ ] Work completed, no further action pending or underway [ ] Terminated for Default

[ ] Work completed, routine administrative action pending or underway [ ] Other (explain)

12. Provide a summary description of contract work. Describe the nature and scope of work, its relevancy to this contract, and a description of any problems encountered and your corrective actions. Also, name the key personnel on this contract work and their relation with this contract (i.e. are resumes provided in your response).