Enclosure1PastPerformanceRecord.pdf

RFP No. W911S2-16-R-8001

Job Order Contract, Fort Drum, New York

Enclosure 1, Past Performance Record

ENCLOSURE 1

PAST PERFORMANCE RECORD

Please provide your candid responses. If you do not have knowledge of or experience with the company in question, please forward this Past Performance Risk Assessment Questionnaire to the person who does.

Please return the completed Questionnaire to nennie.y.gargard.mil@mail.mil on or before the RFP due date.

Thank you.

1. CONTRACTOR IDENTIFICATION

Company Name:

Key Contractor Personnel:

Title: Branch:

e-mail

Phone Number: Fax Number:

Street: P. O. Box

City: State: Zip Code:

2. CONTRACT TITLE:

Description of Work:

Place of Performance:

Government or Non Government (attach additional pages if needed):

3. CONTRACT INFORMATION

Contract Number:

Total Contract Amount: Annual Option Amount:

Date Awarded: Date Completed:

4. CONTRACT TYPE & METHOD (“X” ALL THAT APPLY):

Firm Fixed Price

Fixed Price Incentive Fee

Time and Materials

Other

Cost Plus Fixed Fee

Cost Plus Award Fee

IDIQ

Full & Open Competition

8(a)

Sole Source

Negotiated

Small Business Set-aside

NISH

HUBZone

Other mailto:marisa.m.mustizer.civ@mail.mil

RFP No. W911S2-16-R-8001

Job Order Contract, Fort Drum, New York

Enclosure 1, Past Performance Record

ENCLOSURE 1

PAST PERFORMANCE RECORD

Please provide your candid responses. If you do not have knowledge of or experience with the company in question, please forward this Past Performance Risk Assessment Questionnaire to the person who does.

Please return the completed Questionnaire to nennie.y.gargard.mil@mail.mil on or before the RFP due date.

Thank you.

5. GOVERNMENT CONTRACTING OFFICER, ADMINISTRATOR, and/or TECHNICAL INSPECTOR

(please include title) or PRIVATE SECTOR EQUIVALENT:

CONTRACTING OFFICER/CONTRACT ADMINISTRATOR

Contracting Officer/Contract Administrator Organization Name

Street: P. O. Box

City State: Zip Code:

Name of Contracting Officer/Contract Administrator:

e-mail:

Phone Number: Fax Number:

Street: P. O. Box

City State: Zip Code:

COR/TECHNICAL MONITOR

COR/Technical Monitor’s Organization Name

Street: P. O. Box

City State: Zip Code:

Name of COR/Technical Monitor:

e-mail:

Phone Number: Fax Number:

Street: P. O. Box

City State: Zip Code:

mailto:marisa.m.mustizer.civ@mail.mil