Attachment_1_-_Past_Project_Form.doc

HSHQEC-17-Q-00012

ATTACHMENT 1

PAST PROJECT FORM

1. Name of Contractor

1a. Solicitation Number (i.e. the solicitation your firm is responding to)

2. Complete Name of Government Agency, Commercial Firm, or Other Organization for Which Effort Performed.

3. Complete Address of Entity Named in #2 Above

4. Contract Number or Other Reference

5. Date of Project Award

6a. Total Project Price (to include all options):

6b. Current Annual Estimated Price:

7. Period of Performance (to include all options)

8. Technical Point of Contact (name, title, address, telephone no., and email address)

9. Contracting or Purchasing Point of Contact (name, title, address, telephone no., and email address)

10. Contractor Performance Assessment Reporting System (CPARS) Completion: CPARS is a web-enabled application that collects and manages contractor performance assessments. A CPAR report is required to be completed annually through the conclusion of the contract. Once “finalized” CPAR assessments are copied to the Past Performance Informational Retrieval System (PPIRS). Contractors may view their own data in PPIRS at http://www.ppirs.gov/.

Contractor Complete the Following by Checking the Appropriate Box:

□ A “finalized” Contractor Performance Assessment Report IS resident in PPIRS for this contract for the most recently completed performance period.

□ A “finalized” Contractor Performance Assessment Report IS NOT resident in PPIRS for this contract for the most recently completed performance period..

11. Description of Contract Work. In order to establish the relevance of your project to the instant requirement, please describe the scope, magnitude and complexity of this work, comparing and contrasting it to that required under this solicitation. Additionally, describe any unique or unusual requirements of the contract, and performance problems or issues encountered under the performance of the contract.

Instructions for Completing the Past Project Form

Item1 Insert Name of Offeror Item 1a Insert Solicitation Number

Item 2 Insert the complete name of the customer, including parent organization. Do not use acronyms.

Item 3 Insert the customer's complete address, including both post office box and street address, if possible.

Item 4 Insert any contract number or other contract reference used by the customer.

Item 5 Insert the date on which the contract came into existence.

Item 6a Insert the price, as it appeared in the original contract inclusive of all option periods. If the contract included multiple, separately-priced items, add the individual item amounts and insert the total price.

Item 6b Insert the current total annual amount Item 7 Insert the period of performance to include all option periods (if applicable).

Item 8 Insert the name, title, address, telephone number, and email address (if available) of the program or project manager, quality assurance representative, or other customer technical representative who is most familiar with the quality of your work under the contract.

Item 9 Insert the name, title, address, telephone number, and email address (if available) of the contracting officer, purchasing agent, or other customer contracting or purchasing representative who is most familiar with your work under the contract.

Item 10 Indicate whether a “finalized” Contractor Performance Assessment Report is resident in PPIRS by checking the appropriate box.

Item 11 Describe the nature and scope of the work. The objective is to show how the work that you did or are doing is similar in nature and scope to the work that is to be performed under the contract contemplated by the request for proposal. Describe any unique or unusual requirements of the contract and any problems encountered during the performance of this contract work. Tell your side of the story of any conflicts with the customer concerning which they may make adverse remarks about your performance. Describe any actions that you have taken or plan to take to correct any shortcomings in your performance.