Past Performance Info sheet 15 Apr 09

PPIS - 15 April 2009

PAST PERFORMANCE INFORMATION SHEET

Provide the information requested in this form for each contract/program being described. Comments shall be frank and concise regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations set forth in Section L, Instruction to Offerors. If information is provided relevant to task order type contracts, offerors must provide specific task order numbers, in addition to the basic contract number. Past performance submissions for any team member will be evaluated for relevancy based on how that information coincides with the role of the team member on this acquisition.

A. Offer Information

1. Offer Name (Company/Division):

2. Cage Code:

3. DUNS Number:

NOTE: For large, multi-function companies, limit the references to work done by the division, group or unit that plans to perform the proposed work. If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes. Refer to the “Organizational Structure

Change History” you provide as part of your Past Performance Volume.

B. Program Title:

C. Contract Specifics

1. Contracting Agency or Customer:

2. Contract Number:

3. Contract Type:

4. Period of Performance:

5. Original Contract $ Value: (Do not include unexcersized options)

6. Current Contract $ Value: (Do not include unexcersized options)

7. If Amounts for 5 and 6 above are different, provide a brief description of the reason:

D. Brief Description of Effort as: Prime or Subcontractor

(Please indicate whether it was development and/or production, or other acquisition phase, and highlight portions considered most relevant to current acquisition)

(Enter description here – Description may be as long as necessary so long as page size, format, number limitations, etc., as set forth in RFP attachment Section L are adhered to)

E. Completion Date

1. Original Date:

2. Current Schedule:

3. Estimate at Completion:

4. How Many Times Changed:

5. Primary Causes of Change:

F. Primary Customer Points of Contact: (For Government contracts provide current information on all three individuals. For commercial contracts provide points of contact fulfilling these same roles.) It is the contractor’s responsibility to ensure all data is current and accurate.

PPIS - 15 April 2009

1. Program Manager:

Office:

Address, City, State, Zip:

Telephone Number:

Email Address:

2. Contracting Officer:

Office:

Address, City, State, Zip:

Telephone Number:

Email Address:

3. Administrative Contracting Officer:

Office:

Address, City, State, Zip:

Telephone Number:

Email Address:

G. Address any technical (or other) area about this contract/program considered unique:

(Enter description here – Description may be as long as necessary so long as page size, format, number

H. For each of the applicable Subfactors under the Technical Capability factor in Section M, illustrate how the prior contract applies to each Subfactor: NOTE: For Subfactor 3, CSOW, the contractor need only to address those elements defined in paragraph 4.3 in RFP attachment

Section M.

(Enter description here – Description may be as long as necessary so long as page size, format, number

Note: Past performance submissions for any team member will be evaluated for relevancy based on how similar work on the prior contract is to that team member on this particular acquisition.