J.3 Past Performance Information Form.pdf

PDF 75 KB Posted

Attached to
AMENDMENT 1- Prevention of Malaria through Vector Control Federal contract opportunity
Solicitation number
7200AA22R00061
Issued by
US Agency for International Development Bureau for Management

About this file

This document contains a past performance information form template for contractors to submit references on previous relevant contracts for a malaria prevention through vector control support services solicitation issued by the U.S. Agency for International Development. The form requests information on up to five recent and relevant contracts, including the contractor name, awarding entity, contract number, period of performance, value, description of work, and relevance to the solicitation. Contact information is also solicited for the contracting officer, COR or project manager. The related federal contract opportunity provides additional details on the solicitation number, name as the Prevention of Malaria through Vector Control opportunity, type as a solicitation from USAID, and description of supporting the President's Malaria Initiative and USAID missions and bureaus with malaria programs through vector control services as described in the attached RFP.

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Text version

J.3 – PAST PERFORMANCE INFORMATION FORM

List three (3) to five (5) of the most recent and relevant contracts/agreements for efforts similar to the work in the subject proposal. The most relevant indicators of performance are contracts of similar technical scope, size, geographic coverage, and complexity to the Statement of Work.

PART I: Contractor/Award Information

1. Contractor:

2. Information Provided in Response to RFP No.:

3. Name of Awarding Entity:

4. Contract/Award Number:

5. Contract/Award Type:

6. Contract/Award Period of Performance:

7. Contract/Award Value (TEC/TEA): (if subcontract/subaward, subcontract/subaward value)

8. Overall Description of the Award (details that describe the breadth and volume of related transactions; scope of work or complexity/diversity of tasks; and primary location(s) of work):

9. Relevance to the RFP:

10. If extraordinary problems impacted the contract/award, provide a short explanation and the corrective action taken:

Contracts/Awards Contact Information: (Name, Telephone Number, and Email Address)

12a. Contracting/Agreement/Awarding Officer:

12b. Contracting Officer’s Representative (COR)/Agreement Officer’s Representative:

(AOR)/Project Manager:

12c. Other:

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