J.5 Past Performance Information Form.rtf

Form of

SOLICITATION: 1305M221RNMAN01155 ATTACHMENT: J.5

PAST PERFORMANCE INFORMATION FORM

AGENCY OR CLIENT:

CONTRACT NUMBER:

Refer to Section L of Solicitation 1305M221RNMAN01155, Instructions to Offerors, REQUIREMENTS FOR PROPOSAL CONTENT. The offeror shall complete this form in its entirety for each contract identified in the offeror’s Volume I – Technical Proposal.

Check one of the following statements:

CPARS - The referenced Contract Number has a completed CPARS.

Past Performance Questionnaire (Fill-in Data under item 3 prior to sending to Agency/Client POC)

The Point of Contact or Project Manager associated with the work completed under the referenced Contract Number has been sent this form and the Past Performance Questionnaire to complete and return to both the Contracting Officer, Andrew Northcutt and the Contract Specialist, Jessica Loftus, via email at Andrew.Northcutt@noaa.gov and Jessica.Loftus@noaa.gov no later than 12:00 PM ET, August 6, 2021.

Provide the following data in its entirety.

Ship Name, Hull Number:

Dollar Value of the contract (Original: $ and Final: $ )

Type of service performed and whether Prime or Sub Contractor: Type: , Prime or Sub:

Contract performance period at the start of the contract: Start: End:

Actual performance dates upon completion: Begun: Completed:

Contract Type:

Percentage of growth in contract price (Additional work divided by award price) and the extent of Subcontracting:

Growth Percentage: % Extent of Subcontracting:

NOTE: It is the responsibility of the Offeror to follow‐up and to encourage references to submit the questionnaire prior to the solicitation closing date of 12:00 PM ET, August 20, 2021.