Past_Performance_Survey_Att2.docx

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LGBTI PROGRAM EVALUATION SERVICES
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SAQMMA16R0070
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Attachment 2 - Past Performance Survey

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PAST PERFORMANCE SURVEY

Past Performance Profile – Contract/Task Order Number

Offeror:

Performed as Prime or Subcontractor:

Federal Agency Supported:

Points of Contact:

Contractual: COR / COTR:

Name Organization Address Telephone Number FAX Number Email Address

Project Location(s) [State or Country]:

Number of Full-Time Project Personnel:

Actual Annual Contract Dollars (not Contract Ceiling Value):

Original Annual Contract Value:

Actual/Current Annual Contract Value:

Explanation of Variance if applicable:

Period of Performance:

Type of Award (Competitive, Sole-Source, Performance Based, etc)

Contract Type (Firm Fixed Price, Time and Materials, Cost Plus, etc.)

Descriptions of Work Performed, including Scope and Complexity of the Effort:

Technical, Cost or Schedule Problems Encountered and Resolution:

Innovative Solution Applied, Cost-Savings Realized or Recognition Received:

Actual Results Achieved against Performance Standards:

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