FINAL Attachment 1B_Reference Information Sheet - Contract Specific Data.docx

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Attached to
Engineering and Operational Support for Aviation and Polar Programs
Solicitation number
N65236-16-R-0006
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ATTACHMENT 1B

REFERENCE INFORMATION SHEET – CONTRACT SPECIFIC DATA

SOLICITATION N65236-16-R-0006

((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:

Name:
Address:

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):

|_| Work continuing, on schedule|_| Work continuing, behind schedule
|_| Work completed, no further action pending or underway|_| Work completed, routine administrative
|_| Work completed, claims negotiations pending or underwayaction pending or underway
|_| Work completed, litigation pending or underway|_| Terminated for Convenience

|_| 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 subfactor A2 elements A2.1 through A2.4 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.

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