D1_18Q0031_Attachment_1_Past_Performance_Worksheet.docx

Attachment 1 Past Performance Worksheet

Name of Contractor:

Contract Number:

1.Complete name of government agency, commercial firm or other organization

2. Complete address

3. Technical point of contact (name, address, telephone no. and e-mail address)

4. Contracting or purchasing point of contact (name, address, telephone no. and e-mail address)

5. Contract number or other reference

6. Date of contract

7. Date work was begun

8. Date work was completed

9 a. Initial contract price, estimated cost and fee, or target cost and profit or fee

9 b. Final amount invoiced or amount or amount invoiced to date

10. Location of work (country, state or province, county, city)

11. Description of contract work (Describe nature and scope. Attach an explanation of any performance problems or other conflicts with the customer. Describe any litigation pending, on-going, or completed. Use a continuation sheet, if necessary.)

12. Current status of contract (choose one):

Work continuing, on schedule Work continuing, behind schedule Work completed, no further action pending or underway Work completed, routine administrative action pending or underway Work completed, claim negotiations pending or underway Work completed, litigation pending or underway Terminated for convenience Terminated for default Other (explain)