Attachment_5_-_Corp_Experience_Template.docx

SWHARC16R0009 ATTACHMENT 5 – 4 NOV 2016

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104

WHEN COMPLETED, FOR OFFICIAL USE ONLY

SWHARC16R0009 – ATTACHMENT 5

CORPORATE EXPERIENCE REFERENCE TEMPLATE

OFFEROR NAME:

OFFEROR DUNS:

OFFEROR CAGE CODE:

Note: A separate Corporate Experience Corporate Template must be completed for each aircraft.

CONTRACT REFERENCE INFORMATION

Aircraft Description: Include manufacturer name, model number, and aircraft tail number

Customer Identification: Include name, address, email, and telephone number of customer

Name of entity performing the work:

Full address and DUNS / CAGE numbers of entity performing the work:

Contract Number:

Total Contract Value:

Type of Contract (FFP, CPFF, T&M, etc.):

Date Work Started:

Date Work Concluded:

Place of performance:

CERTIFICATIONS / QUALITY STANDARDS

What certifications were required to perform the services?

Under which quality standards were the services provided?

TYPE OF SERVICES RENDERED (check all that apply)

|_| Aircraft condition inspection

|_| Aircraft strip and repaint

|_| Aircraft modifications

|_| Airframe engineering services

|_| Helicopter flight operations as related to the requirements of this solicitation’s SOW

|_| Helicopter transport services

|_| Field services in remote locations

|_| Significant airframe repairs requiring over 250 documented man-hours to complete

USE OF SUBCONTRACTORS / PARTNERS

List the name, address, and DUNS number of any subcontractors or partners utilized in performing the above services.

For each subcontractor / partner listed describe the work performed by each.

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104

WHEN COMPLETED, FOR OFFICIAL USE ONLY