ID07180060_-_Appendix_D_-_Past_Experience_Information_Sheet_12.21.18.pdf

ID07180060 Air Force Civil Engineering Center (AFCEC) HAZMAT Program Support – RAF Lakenheath, UK

APPENDIX D

PAST EXPERIENCE INFORMATION SHEET

Provide the information requested in this form for each contract/program being described. Provide concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations set forth in the task order, Appendix A and B Sections A1.3 and A.1.3.1. Past Experience, of this solicitation.

A. Offeror Name (Company/Division): _________________________________________ CAGE Code: _________________________________________ DUNS Number: _________________________________________ (NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes.)

B. Program Title: _____________________________________________________________

C. Contract Specifics:

1. Contracting Agency or Customer:__________________________________________________

2. Contract Number: __________________________________________________

3. Contract Type: __________________________________________________

4. Period of Performance: __________________________________________________

5. Total Contract $ Value: ________________________(Total cost to inlcude all options)

6. Current Contract $ Value: _____________________ (Do not include unexercised options)

D. Brief Description of Effort as __Prime or __Subcontractor (Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition):_________________________________________

E. Milestones:

1. Start Date: ____________________________________________________

2. Completion Date: ____________________________________________________

F. Primary Customer Points of Contact: (For Government contracts provide current information on both individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

Client Program Manager and/or Site Manager Information

Name Office Telephone E-Mail

Contracting Officer Information

Name Office Telephone E-Mail

G. Describe in as much detail as possible why this experience is relevant with respect to the scope of the overall task and to the requirements as described in PWS. Scope is defined as the range of work/skills being referenced is similar in nature to the requirements identified in the SOW/PWS. Please reference back to Appendix B, Section 1.3 Past Experience (PE) “similar” language.