Amendment_5_-_J.P-7_CTA_Template.pdf

Alliant 2 Small Business GWAC Solicitation No.: QTA0016GBA0002

J.P-7 Contractor Teaming Arrangement Template

ATTACHMENT J.P-7

CONTRACTOR TEAMING ARRANGEMENT TEMPLATE

General: This form is to be sent to the members of the Offeror's existing or previous Contractor Team Arrangement (CTA) to validate the Offeror's performance under a project awarded to the CTA.

This form shall be signed by a majority of members in the CTA, excluding the offeror. The Government will use this information solely for source selection purposes under the Alliant 2 Small Business RFP.

CTA Members: You are receiving this form because the Offeror cited in Part I claims that they performed the project identified in Part II as a member of your CTA and is using the project as relevant experience for its Alliant 2 Small Business proposal.

By signing this form in Part IV you are certifying that the Offeror was the only CTA member that performed the project and that no other CTA member, or the CTA, shall claim credit for this project.

By completing this form, you are not required to make changes to any existing documents or systems related to the project awarded to your CTA. If you have any questions about this document, please email A2SB@gsa.gov.

Offeror: Part I, II, and III shall be completed by the Offeror. To complete this form, place the cursor in the highlighted area and begin typing. All responses in Part II, III and IV shall match what is entered into the corresponding Attachment J.P-2 (Relevant Experience (PSC Group) Project Template) or J.P-4 (Relevant Experience (Leading Edge Technology) Project Template). After completing Parts I, II, and III, the Offeror shall send this form to the CTA members and shall be signed by at least the majority of members, excluding the Offeror. After receiving the completed form, you must save this document to your computer as a pdf file and name this file in accordance with Section L.4.1.

PART I: OFFEROR AND CTA INFORMATION

OFFEROR NAME:

CONTRACTOR TEAMING

ARRANGEMENT NAME:

CONTRACTOR TEAMING

ARRANGEMENT DUNS:

NUMBER OF CTA MEMBERS:

PART II: PROJECT IDENTIFICATION

CONTRACT NUMBER:

ORDER NUMBER (if applicable):

PROJECT TITLE:

AGENCY OR CUSTOMER:

TOTAL PERIOD OF PERFORMANCE,

INCLUDING OPTIONS: (MM/YYYY -

MM/YYYY or MM/YYYY – Present)

PART III: OFFEROR CERTIFICATION

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER:

DATE:

SIGNATURE:

PART IV: CTA MEMBER CERTIFICATION

Each CTA member shall have a Corporate Officer certify by signing below that they are a member of the CTA identified in Part I, and that the Offeror stated in Part I was the only CTA member that performed the project and that no other CTA member, or the CTA, shall claim credit for this project identified in Section II. Each CTA Member that chooses to sign this form will fill out one of the CTA Member boxes, sign and date and send back to the Offeror.

CTA Member #1:

CTA MEMBER NAME:

CTA MEMBER DUNS:

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER:

CTA Member #2:

CTA MEMBER NAME:

CTA MEMBER DUNS:

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER:

CTA Member #3:

CTA MEMBER DUNS:

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER:

CTA Member #4:

CTA MEMBER DUNS:

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER:

CTA Member #5:

CTA MEMBER DUNS:

I certify that the Offeror identified in Part I was the only CTA member that performed the project identified above.

NAME:

TITLE:

EMAIL:

PHONE NUMBER: