J - 12 Past Performance Data.doc.PDF

N3220518R4003

USNS PATUXENT (T-AO 201) ROH

PAST PERFORMANCE DATA

1. Complete Name of Reference (Government agency, commercial firm, or other organization)

2. Complete Address of Reference

3. Contract Number or other control number 4. Date of contract

5. Date work was begun 6. Date work was completed

7. Contract type, initial contract price, estimated cost and fee, or target cost and profit or fee

8. Final amount invoiced or amount invoiced to date

9a. Reference/Technical point of contact (name, title, address, telephone

no. and email address)

9b. Reference/Contracting point of contact (name, title, address, telephone no. and email address)

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

11. Current status of contract (choose one):

[ ] Ongoing [ ] Complete [ ] Terminated for Convenience [ ] Terminated for Default [ ] Other (explain)

12. Provide a summary description of contract work. Discuss relevant past performance of offeror, as a prime contractor and/or subcontractor, and of key personnel in the overhaul, repair, and alteration of ships within the last three years that is comparable or related to the work or effort required by this solicitation.

13a. Did this contract require a Small Business Subcontracting Plan pursuant to FAR 52.219-9? Yes __, No__.

13b. If “Yes” to 13a, have you regularly submitted your reports in the Electronic Subcontract Reporting System (ESRS) in a timely manner? Yes __, No__.

If no, why not?

14. All offerors should address historical compliance with the requirements of FAR Part 52.219-9 ALT II (Small Business Subcontracting Plan (DEVIATION 2016-O0009), Contracting by negotiation, and subcontracting plans are required with initial proposals as provided for in FAR 19.705(d)) and 252.219-7003 (Small Business Subcontracting Plan (DoD Contracts) (DEVIATION 2016-O0009) changes the entity to which the contractor submits the SSR in the Electronic Subcontracting Reporting System (eSRS) for an ISO from the military department or defense agency to DoD.

ATTACHMENT J - 12