ATT_4_Past_Performance_Form.docx

DOCX document 32 KB Posted

Attached to
Voluntary Medical Male Circumcision (VMMC) Service Delivery III Project in South Africa
Solicitation number
SOL-674-16-000034
Issued by

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ATT 4 - Past Performance Form

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RFP No. SOL-674-16-000025 USAID/Southern Africa/VMMC III

ATTACHMENT 4

PAST PERFORMANCE INFORMATION (PPI)

The following form is included in the solicitation to guide Offerors in responding to the PPI proposal instructions. The form is not required if the below information is available in the Government past performance systems.

(To be completed by the offeror)

1. Contract Number:

2. Contractor (Name and Address):

3. Customer Agency/organization:

4. Does a CPARS/PPIRS record exist for this work? (Yes or No)

5. Type of Contract: Negotiated Sealed Bid Fixed Price Cost Reimbursement _____ Hybrid (explain) _______________________

6. Complexity of Work: Difficult Routine

7. Description, location, and relevancy of work:

8. Contract Dollar Value: Status: Active Completed

9.Date of Award:
Contract Completion Date (including extensions):_____

10. Type and Extent of Subcontracting:

11. Name, Address, Telephone Number, and E-mail Address of the Procuring Contracting Officer and/or the Contracting Officer ’s Representative (and other references—e.g., Administrative Contracting Officer —if applicable):

Source Selection Information - See FAR 2.101 and 3.104

File details come from the government source that posted it. Updated .