Annex_1_Past_Performance_Information.docx

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Cambodian Civil Society Strengthening (CCSS) Project
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SOL-442-15-000012
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Revised Annex 1 Past Performance Information

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ANNEX 1

CONTRACTOR/SUBCONTRACTOR PAST PERFORMANCE INFORMATION

for _______________________________________ [insert the name of the company and check below as applicable]

[ ] prime offeror [ ] subcontractor under proposal by _____________________________ [insert the name of the prime offeror]

1. Contracting Entity Name & Address:

2. Contracting Entity Contacts (name, title, mailing address, phone number, e-mail address):

3. Contract/Agreement No.:

4. Contract/Agreement Type:

5. Place of Performance:

6. Term of Performance:

7. Dollar Value of the Contract/Agreement:

8. Resources Leveraged (if any):

9. Scope of Work/Services/Activity, Complexity/Diversity of Tasks, Required Skills & Expertise:

10. Problems & Corrective Actions (if any):

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