PAST_PERFORMANCE_INFORMATION_FORM.doc

PAST PERFORMANCE INFORMATION FORM RFP N0018918RZ007

Form _1__ of 3

Name of Quoter:

Contract Number:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number (PLEASE VERIFY):

Total dollar amount (receipts) for this contract during the past five years (60 months prior to APRIL 2018):

(For ordering agreement, show both the annual maximum contract amount and the amount of orders actually performed.)

Number of personnel (FTE) provided per year (average):

To:

Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the RFP’s PWS:

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: