Attachment 1A and 1B - Reference Information Sheet - Summary and Contract Specific Data.docx

ATTACHMENT 1A

REFERENCE INFORMATION SHEET – SUMMARY DATA

SOLICIATION N65236-16—R-0005

**Prime and Subcontractors are to submit separate sheets.**

Contractor Name: _______________________________________ CAGE Code: _______________

Address: _________________________________________________________________

Division (If Applicable): _______________________________________________________________

Contractor Point of Contact Information (Representative who can verify data):

Name: ______________________________________________________________

Telephone Number: (____) _____________________________

Fax Number: (____) _____________________________

E-Mail Address: ____________________________________

In the table below, identify the contract references submitted for evaluation under the Technical Capability Factor:

Past Performance:

NOTE: In accordance with Section L provision L-317, Submission of Proposals, if the offeror’s Contractor Performance Assessment Report (CPAR) for the contract(s) referenced is located in the PPIRS, then it is not necessary for a Past Performance Questionnaire to be submitted.

1A

ATTACHMENT 1B

REFERENCE INFORMATION SHEET – CONTRACT SPECIFIC DATA

SOLICIATION N65236-16—R-0005

(Reproduce this form as needed for each Contract Reference Cited) NOTE: If submitting multiple orders under a single GSA, GWAC, DoD-wide contract or BPA in order to meet the relevancy threshold for a contract reference, offerors shall clearly identify the dates of performance and dollar amounts for each order.

1. Contract Number or other Control Number (Identify individual Task Orders if applicable):

2. Complete Name and Address of Contract Reference:

3. Date of Contract:

4. Date work began:

5. Date work was completed:

6. Contract Information:

Contract Type:

Initial Contract Amount (Total Ceiling):

Final (or Current) Contract Amount (Total Ceiling) (if different from Initial):

7. Final amount invoiced or amount invoiced to date:

8. Technical Point of Contact for this Reference:

Name:

Telephone #: ( ) - - E-Mail:

9. Contracting Point of Contact for this Reference:

Name:

Telephone #: ( ) - - E-Mail:

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

11. Current status of contract (choose one):

|_| Terminated for Default |_| Other (explain)

12. Did this contract require a Small Business Subcontracting Plan (FAR 52.219-9)? |_| Yes |_| No If "Yes”, attach a copy of your most recently submitted eSRS Subcontracting Report for Individual Contracts, for the contract reference or, if no subcontracting plan required, provide a copy of your company’s Summary Subcontract Reports.

13. Provide contract specific technical capabilities data that addresses the subfactors identified in provision L-317. Describe the nature and scope of work, its relevancy to this requirement, any proposed benefits of the experience to the Government, and a description of any problems encountered and your corrective actions.

1B