ATTACHMENT_B_-_EXPERIENCE_PP_REFERENCE.pdf

ATTACHMENT B

EXPERIENCE - PAST PERFORMANCE REFERENCE

The past performance narrative content shall be restricted to the same content required in Volume I – Factor 1 – Technical Capability and Management. (May be modified/formatted as needed but offeror’s proposal shall contain at a minimum all the information below. This form is not included in the page count.)

SOLICITATION NO. W912DY-16-R-0046

PROJECT EXPERIENCE FORM

Please provide a completed form for each project for which experience is being claimed (Offeror fills out this section).

Name of Offeror: __________________________________________________

Name of Project: __________________________________________________

Location of Project: ________________________________________________

Contract Number Project Performed Under: _______________________ Task Order Number: ________

Was the Project Firm-Fixed Price or Cost Reimbursable (including Time & Materials)?

Was the offeror the prime contractor or subcontractor? __________________________________________

If the offeror was the prime contractor, please explain primary role/duties: ________________________

Brief Description of Project (Offeror can add attachment provided page count is not exceeded.)

Contract Amount at Award: _____________________________________________

Final Contract Amount: ________________________________________________

Amount added by Modification: _________________________________________

Explanation of any Cost Growth/Overruns: _____________________________________________________

Multiple Interim Schedule Milestones (to include scheduled start date): ___________________________

Original Contract Completion Date: ____________________________________

Final Contract Completion Date: _______________________________________

Actual Completion Date: ______________________________________________

Time added by Modification: ___________________________________________

Explanation of any Late Finish: _______________________________________________________________

Additional Project Information (Offeror can add attachment provided page count is not exceeded):

Was the project terminated early or were cure/show cause letters received? Yes No Explain early termination (default/convenience) or cure/show cause letters.

Safety record: ____ Accidents, ____ Incidents, ____Violations List and explain any customer concerns or dissatisfaction

What were the SDB, WOB and small business percent goals in the original contract, if any? N/A________SDB:______ WOB:

_____ Small Business: ______ HUBZONE: ______ SDVOSB: _______

What was the actual percent achieved at contract completion?

N/A______SDB: ______ WOB: _____ Small Business: _____ HUBZONE: ______ SDVOSB: _______

Was the project owner an agency of the federal government? Yes No

Name, address, FAX and telephone number of the owner:

Name and telephone number of a representative of your firm who is knowledgeable of this project and can readily be contacted:

Name, address, FAX and telephone number of a representative of the owner who is knowledgeable of this project and can be readily contacted:

Name, address, FAX and telephone number of the Contracting Officer if project was for federal government: