Past_Performance_Info-Attachment_4.doc

Past Performance Information

Please provide THREE (3) past performance references for work completed during the past three years (2013, 2014, and 2015) or currently in process for the same type of services as are being solicited under this solicitation. The government reserves the right to contact individuals and companies/agencies other than those listed on this form to collect additional past performance information. Further, any information contained in the US Government’s Past Performance Information Retrieval System (PPIRS) may also be reviewed in the evaluation of past performance.

Company Information Company Name:

Address:

Phone:

Fax:

Email:

Reference Information #1

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Reference Information #2

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Reference Information #3

Company/Agency:

Current POC:

Phone:

Email:

Service/Product Provided:

Dollar Value of Contract:

Date of Contract Award:

Contract Number:

Documented Environmental Violations and Corrective Action Taken, if any:

Past Performance Information Sheet