Attachment_L-1_Present_and_Past_Performance_Information_Form_23_Dec.doc

HDTRA1-16-R-0011

ATTACHMENT L-1

PRESENT AND PAST PERFORMANCE INFORMATION FORM

ADVISORY AND ASSISTANCE SERVICES (A&AS) SUPPORT

FOR THE

J10 NUCLEAR ENTERPRISE SUPPORT DIRECTORATE ORGANIZATIONS

SOLICITATION NUMBER: HDTRA1-16-R-0011

Provide the information requested in this form, for each contract/program being assessed for past or present performance. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate form for each contract/program submitted.

1.

Offeror Name (Company/Division):

CAGE Code:

DUNS Number + 4:

2.

Program Title:

3.

Contract Specifics:

a. Contracting Agency or Customer

b. Contract Number

c. Contract Type

d. Role (check one) Prime_______ Sub_______

e. Period of Performance

f. Original Contract $ Value ________________ (Do not include unexercised options)

g. Current Contract $ Value ________________ (Do not include unexercised options)

h. Total Contract $ Value ________________ (Include unexercised options)

i. If amounts for (f) and (g) above are different, provide a brief description of the reason:

4. Primary Customer Points of Contact:

(For Government contracts, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

a. Program Manager:

Name

Office

Address

Telephone

E-mail

b. Contracting Officer:

c. Administrative Contracting Officer (if applicable):

5. Specifically define and detail the relevance of this past performance effort in relation to the specific tasks you will be performing in the RFP PWS requirements. Offeror’s shall specifically cite the applicable PWS sections (i.e. PWS 3.3.1) their past experience and how this experience is relevant to the J10 Requirement (emphasis on the relevancy in relation to the scope, magnitude, and complexity of the PWS requirements).