PAST_PERFORMANCE_INFORMATION_FORM.doc

CORPORATE EXPERIENCE and PAST PERFORMANCE INFORMATION FORM Form ___ of _3__

Name of Offeror:

Contract Number, order number, or identifier:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number (PLEASE VERIFY):

and e-mail address

Annual dollar amount for this effort during the past five (5) years:

(For ordering vehicles, show both the annual estimated contract amount and the amount of orders actually performed):

(Show calendar year and dollars)

Number of personnel (FTE) performing per year (avg.)

(list and indicate break-down of FTE per contractor under this reference if subs are utilized) Example:

Prime: 75FTE

Sub1: 20 FTE

Sub2: 5 FTE

To:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the solicitation:

Quality, delivery, or cost problem(s); corrective action(s) taken; and effectiveness of the corrective action(s):

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts:

Example: Sub1 performed 20% (and list annual dollar value) of work performed under subject contract, Sub2 performed 5% (and list annual dollar value) of the work performed under subject contract. The type of work performed by Sub1 and Sub2 is as follows…