JA8 Past Performance Information Questionnaire.pdf

Provide the information requested in this form for each project being submitted. Provide frank, concise comments regarding your performance on the contracts you identify.

A. OFFEROR NAME (COMPANY/DIVISION) AND LOCATION (CITY/STATE):

(NOTE: IF THE COMPANY OR DIVISION PERFORMING THIS EFFORT IS DIFFERENT THAN

THE OFFEROR, OR THE RELEVANCE OF THIS EFFORT TO THE ACQUISITION IS IMPACTED BY ANY

COMPANY/CORPORATE ORGANIZATIONAL CHANGE, NOTE THOSE DIFFERENCES/CHANGES AND

EXPLAIN WHY THE PAST PERFORMANCE SHOULD BE ATTRIBUTED TO THE OFFEROR.)

B. PROJECT TITLE:_________________________________________________

C. CONTRACT SPECIFICS:

1. Contract Number __________________________________________

2. Contract Type _____________________________________________

3. Period of Performance ______________________________________

4. Original CONTRACT $ Value _________________________________

5. Current Contract $ Value ____________________________________

(NOTE: If Amounts for 4 and 5 above are different, provide a brief description of the reasons for the difference.)

D. BRIEF DESCRIPTION OF EFFORT AS ____PRIME OR ____SUBCONTRACTOR.

(Please highlight portions considered most relevant to current acquisition)

E. COMPLETION DATE:

1. Original Contractual Date: __________________________

2. Current Schedule: __________________________

3. Estimated Date of Completion: __________________________

4. How Many Times Changed: __________________________

5. Primary Causes of Change: __________________________

F. PRIMARY PROJECT REFERENCE POINTS OF CONTACT:

(Please provide current information on all individuals)

Name: ______________________________ Office ______________________________ Address ______________________________

Telephone ______________________________ E-mail ______________________________ Fax ______________________________

G. ADDRESS ANY TECHNICAL (OR OTHER) AREA ABOUT THIS PROJECT CONSIDERED

UNIQUE.

H. SPECIFY BY NAME ANY KEY INDIVIDUAL(S) WHO PARTICIPATED IN THIS PROJECT AND

IS/ARE PROPOSED TO SUPPORT THE INSTANT ACQUISITION. ALSO, INDICATE THEIR

CONTRACTUAL ROLES FOR BOTH ACQUISITIONS.

Eielson AFB SMR Attachment 8 SP0604-22-R-0421

Past Performance Questionnaire

I. ADDRESS PROBLEMS ENCOUNTERED ON THIS CONTRACT AND YOUR SOLUTIONS TO THOSE

PROBLEMS.

J. GENERAL

Indicate (yes or no) if you owned, operated, maintained the system for the referenced customer. Indicate if the systems were located on the customer’s site.

OWN OPERATE MAINTAIN ON SITE

Camp Roberts/USASA Resilience Attachment 8 SPE604-20-R-0402