HSHQEH-17-Q-00004_Past_Project_Form.doc

HSHQEH-17-Q-00004

ATTACHMENT 2

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):

7. Period of Performance (to include all options)

8. Level of Security Clearance Required (If applicable)

(If applicable) Type/Level:

9a. Technical Point of Contact (name, title, address, telephone no., and email address)

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

10. Geographic Location of Work (Country, State or Province, County, City)

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.