J-9_Past_Performance_Information_(PPI)_Form.docx

J-9 PAST PERFORMANCE INFORMATION (PPI) FORM

Form ___ of ___

Name of Offeror:

Contract Number, order number, or identifier:

Customer/Agency Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number and e-mail address (PLEASE VERIFY):

Contract Type:

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)

Period of Performance:

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

Scope:

Magnitude:

Complexity:

Utilization of Small Business Concerns:

Compliance with Small Business Subcontracting Plan:

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

Source Selection Information – See FAR 2.101 and 3.104