W911QY-19-D-0003_ETSSLS_Attachment_0010_Past_Performance_Information.pdf

ATTACHMENT 0010: PAST PERFORMANCE INFORMATION

Provide the information requested in this form for each contract/program ( citation) being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of citations submitted and the length of each submission to the limitations set forth in Section L of this solicitation.

A.

Offeror Name (Company/Division):

CAGE Code:

DUNS Number:

Business Size Status:

(NOTE: 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 provided 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. Initial Contract Cost/Price:

6. Current/Final Contract Cost/Price:

7. Annual Contract$ Value:

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

D. Brief Description of Effort (check one)

Prime

Subcontractor

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

E. Completion Date

1. Original Date:

2. Current Schedule:

3. Estimate at Completion:

4. How Many Times Changed:

5. Primary Causes of Change: