D1 Att 1 - Past Performance Worksheet.pdf

ATTACHMENT 1 - PAST PERFORMANCE WORKSHEET

(To Be Completed by Quoter/Contractor)

M0068122Q0017 1

Solicitation Number: M0068122Q0017

Subject: Unit Deployment Storage Services

1. Complete name of Government Agency, Commercial Firm, or Organization

2. Complete Mailing 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

6. Award Date

7. Performance Start Date

8. Performance End Date

9a. Initial contract price, estimated cost, or target cost

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

10. Is there a current Contractor Performance Assessment Reporting System (CPARS) report available:

Yes No

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.) Remember, work should be recent and relevant to the subject solicitation.

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):

13. Number of locations supported:

One-Two

Three-Five

Six-Eight

Nine-Ten

More than Ten

Other: