J.P-2 Joint Venture Experience Template PolarisHUBZone.docx
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- 47QTCB22R0006
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Polaris GWAC Program Attachment J.P-2
ATTACHMENT J.P-2
JOINT VENTURE EXPERIENCE TEMPLATE
In accordance with Section L.5.1.3.3, an Offeror may use experience performed as a member of an existing or previous joint venture. In these situations, the Offeror must submit this completed template identifying the work performed as part of the joint venture for the contract or order. This template may not be used for purposes other than experience claimed in accordance with Section L.5.1.3.3.
Offeror: Parts I, II and IV must be completed by the Offeror.
After completing Parts I, II and IV, if verification of the contract/order is not provided by FPDS in accordance with L.5.2.2.1.1(1), the Offeror must send this form to the cognizant Contracting Officer, Contracting Officer’s Representative, other Government employee or Corporate Officer/Official for verification in accordance with L.5.2.2.1.1(2), L.5.2.2.1.2 and/or L.5.2.3.1.1. The cognizant Contracting Officer, Contracting Officer’s Representative, other Government employee or Corporate Officer/Official must provide this verification within Part III of this form. The Offeror then must send this form to another member of the Joint Venture to verify in Part IV the work performed by the Offeror as identified within the Project Verification Form. After receiving the completed form, it must be submitted with the claimed Relevant Experience Project within the proposal.
Joint Venture Member: You are receiving this form because the Offeror (cited in Part I) claims that it performed the project identified in Part IV as a member of your joint venture and is using the project as relevant experience for its Polaris proposal.
By signing this form in Part V you are verifying the Offeror performed the work detailed in Part IV while a member of the joint venture.
Customer: You are receiving this form because the Offeror (cited in Part I) claims that it performed as a member of a joint venture (also cited in Part I) and is using the project as relevant experience for its Polaris GWAC proposal.
By signing this form in Part III, you are verifying the joint venture performed the work as detailed in Part II.
PART I: OFFEROR AND JOINT VENTURE INFORMATION
| OFFEROR’S NAME: |
| Click or tap here to enter text. |
| JOINT VENTURE NAME: |
| Click or tap here to enter text. |
| JOINT VENTURE UEI: |
| Click or tap here to enter text. |
PART II: JOINT VENTURE CONTRACT/ORDER INFORMATION
| CONTRACT NUMBER: |
| Click or tap here to enter text. |
| ORDER NUMBER (if applicable): |
| Click or tap here to enter text. |
| PROJECT NAME: |
| Click or tap here to enter text. |
| FUNDING AGENCY ID OR CUSTOMER: |
| Click or tap here to enter text. |
| TOTAL PERIOD OF PERFORMANCE, INCLUDING OPTIONS: (MM/YYYY – MM/YYYY or MM/YYYY – Present) |
| Click or tap here to enter text. |
| TOTAL CONTRACT/ORDER DOLLAR VALUE: |
| Click or tap here to enter text. |
| NAICS: |
| Click or tap here to enter text. |
| COST REIMBURSEMENT: (Y/N) |
| Choose an item. |
| OCONUS: (Y/N) |
| Choose an item. |
| EMERGING TECHNOLOGY: (Y/N. IF Y, IDENTIFY EMERGING TECHNOLOGY PROVIDED) |
| Choose an item. |
Click or tap here to enter text.
| CYBERSECURITY SERVICES: (Y/N) |
| Choose an item. |
PART III: CUSTOMER CERTIFICATION
(IF APPLICABLE PER SECTION L.5.1.3.3, L.5.2.2.1.1, L.5.2.2.1.2, AND/OR L.5.2.3.1.1) I certify that the Joint Venture identified in Part I performed the project as detailed above in Part II.
| NAME: |
| Click or tap here to enter text. |
| TITLE: |
| Click or tap here to enter text. |
| AGENCY OR CUSTOMER: |
| Click or tap here to enter text. |
| EMAIL: |
| Click or tap here to enter text. |
| PHONE NUMBER: |
| Click or tap here to enter text. |
| SIGNATURE: |
| DATE: |
| Click or tap here to enter text. |
PART IV: PROJECT INFORMATION (WORK PERFORMED BY OFFEROR)
| TOTAL DOLLAR VALUE OF WORK PERFORMED BY OFFEROR: |
| Click or tap here to enter text. |
| NAICS: |
| Click or tap here to enter text. |
| COST REIMBURSEMENT: (Y/N) |
| Choose an item. |
| OCONUS: (Y/N) |
| Choose an item. |
| EMERGING TECHNOLOGY: (Y/N. IF Y, IDENTIFY EMERGING TECHNOLOGY PROVIDED) |
| Choose an item. |
Click or tap here to enter text.
| CYBERSECURITY SERVICES: (Y/N) |
| Choose an item. |
PART V: JOINT VENTURE MEMBER CERTIFICATION
I certify that the Offeror identified in Part I performed the project as detailed in Part IV.
| JV MEMBER NAME: |
| Click or tap here to enter text. |
| JV MEMBER UEI: |
| Click or tap here to enter text. |
| NAME: |
| Click or tap here to enter text. |
| TITLE: |
| Click or tap here to enter text. |
| EMAIL: |
| Click or tap here to enter text. |
| PHONE NUMBER: |
| Click or tap here to enter text. |
| SIGNATURE: |
| DATE: |
| Click or tap here to enter text. |
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