ID08200042 - Attachment 3 - Past Performance Data Sheet.doc

ID08200042

ATTACHMENT 3

Past Performance Data Sheet

1. Project No. (check one) : FORMCHECKBOX

#1 FORMCHECKBOX

#2 FORMCHECKBOX

#3

Submission of Master contract vehicles (e.g., Blanket Purchase Agreements, Indefinite Delivery/Indefinite Quantity contracts) is not permitted. Each Past Performance Data Sheet shall be for one contract or one order.

Vendor Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Contract Number: Delivery/Task Order Number:

Title:

Location:

Award Amount:

Final Price:

3. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

4. Type of Contract/Task Order: (Check ALL that apply)

FORMCHECKBOX

Firm-Fixed Price FORMCHECKBOX Cost/Time and Material FORMCHECKBOX Other (explain):

5. Customer/Owner Name:

Customer POC:

Organization:

POC Phone Number:

POC E-mail address:

Government POC (if other than POC listed above):

Organization:

POC Phone Number:

POC E-mail address:

6. Provide a detailed description of the project and the relevancy to the project requirements of this RFQ. Within the description, identify how the selected project meets the definition of “Similar Contract/Task Order work.”

7. Other Information:

PAGE