18Q0346_Attachment_5_-_Past_Performance_Info_Form.pdf

Source Selection Information – See FAR 2.101 and 3.104

To be completed by the Offeror and returned with the offer:

PAST PERFORMANCE INFORMATION FORM Form ___ of ___

Name of Offeror:

Contract Number, order number, or identifier:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number and e-mail address

(PLEASE VERIFY):

Total dollar value for this effort broken into annual increments:

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

(Show the period of performance and dollars for that period) (*At least 1 year of performance must have been completed prior to the issue date of the solicitation):

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

Period of Performance: From:

To:

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

N3904018Q0346 Attachment 5 - Past Performance Info