Atch 4 PP Reference Submission Sheet - Amend 1.docx

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Attached to
Customer Satisfaction Survey (CSS) RFP
Solicitation number
HTC711-20-R-R021
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HTC711-20-R-R021

Attachment 4

PAST PERFORMANCE SUBMISSION SHEET

(Limited to 1 page per contract)

PROJECT TITLE:______________________________________________________________

BRIEF DESCRIPTION OF SERVICES: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CONTRACTING AGENCY/CUSTOMER:_________________________________________

CONTRACT NUMBER:________________________________________________________

CONTRACT DOLLAR VALUE (including options):__________________________________

TOTAL PERIOD OF PERFORMANCE (including options):____________________________

CONTRACTING OFFICER/PROGRAM MANAGER for this reference (please ensure this information is current)

Name:_________________________________________________________________

Address:_______________________________________________________________

Fax:___________________________________________________________________

Telephone number:_______________________________________________________

Email address:___________________________________________________________

File details come from the government source that posted it. Updated .