Attachment 3 - Relevant Expereince Form.doc
DOC document 38 KB Posted
- Attached to
- SATCOM CB ISEA Support
- Solicitation number
- N65236-18-R-0081
About this file
This document contains a sources sought notice and draft performance work statement for SATCOM CB ISEA support services. The Navy is seeking small businesses to provide In-Service Engineering Agent support for Satellite Communications systems to the Fleet across the SPAWAR enterprise. The anticipated contract type is for discrete performance work statement requirements to support Program Executive Office Command, Control, Communications, Computers, and Intelligence and the Fleet Readiness Directorate. An industry day will be held on March 13, 2019 at Camp Pendleton to discuss a draft evaluation factors and performance work statement. The response deadline for capabilities statements was extended to June 1, 2018. The notice seeks information on relevant experience and past performance for consideration in a potential future solicitation.
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ATTACHMENT 3
RELEVANT EXPERIENCE FORM
SOLICITATION N65236-18-R-0081
(Note: Offerors are not to change the spatial structure of this form, i.e. borders, block size, etc.)
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):
[ ] Work continuing, on schedule [ ] Terminated for Convenience
[ ] Work continuing, behind schedule [ ] Terminated for Default
[ ] Work completed, no further action pending or underway [ ] Other (explain)
[ ] Work completed, routine administrative action pending or underway
[ ] Work completed, claims negotiations pending or underway
[ ] Work completed, litigation pending or underway
12 Provide a summary description of contract work in the box provided. Describe the nature and scope of work and its relevancy to this contract.
14a. Did this contract require a Small Business Subcontracting Plan pursuant to FAR 52.219-9? Yes ___ , No ___.
14b. If “Yes” to 14a, have you regularly submitted Individual Subcontracting Reports (ISR)/Summary Subcontract Reports (SSR) on time? Yes ___ , No ___.
14c. Attach a copy of your most recently submitted SF ISR.
N66001-16-R-0118 Source Selection Information—See FAR 2.101 and 3.104 27 April 2017
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