CONTRACT_DESCRIPTION_FORM.docx

CONTRACT DESCRIPTION FORM

Volume 1, Tab C, Section 1 Control No.: W912PP18R0029

Provide a completed form for each project for which experience is being submitted. Project experience submitted by the Offeror as a subcontractor will not be evaluated.

1. OFFEROR’S NAME (Prime Contractor): ____________________________________________

Project Name: __________________________________________________________________

Project Location: ________________________________________________________________

Client/Customer: ________________________________________________________________

1. Contract Number: _________________________________________________ (For Indefinite Delivery type contracts, GSA contracts, and Blanket Purchase Agreements, include Delivery Order Numbers)

Contract Type (e.g. Fixed-Priced, Cost Reimbursement, etc.): ____________________________

Awarded price/cost: __________________________

Period of Performance (month/year)____to_____

Final or projected final price/cost: _____________________________

Original delivery schedule (include dates of start and completion): ________________________

Final or projected delivery schedule (include dates of start and completion): _________________

Percent of Completion (if project is currently underway) _________________________

1. Client/Customer Point of Contact: __________________________________________________ Address: ______________________________________________________________________ Email: ______________________________ Fax: ________________________________ Telephone: ___________________________

1. Government Contracting Activity/Agency (if applicable): _______________________________ Address: ______________________________________________________________________ Contracting Officer: _____________________________________________________________ Email: ______________________________ Fax: ________________________________ Telephone: ___________________________

Government Contract Administration Activity (if applicable): ____________________________ Administrative Contracting Officer (ACO): ___________________________________________ Contracting Officer Representative (COR): ___________________________________________ Address: ______________________________________________________________________ Email: _________________________________ Fax: ___________________________________ Telephone: ______________________________

(e) Description of project: (Provide a specific narrative explanation of the contract and objectives achieved. Detail how the effort is relevant to the requirement of this RFP):

1. If contract did not meet original schedule or technical performance requirements, provide a brief explanation of the reason(s) for the shortcomings and any corrective action(s) taken to avoid recurrence:

(g) List each time the delivery schedule was revised and provide an explanation of why the revision was necessary. Address all Requests for Deviation and Requests for Waiver with respect to causes and corrective actions: ________________________________________________________________________________

(h) Was the project terminated early or was Cure Notices or Show Cause Letters received on this contract? Yes ____ No____: If yes, explain nature of termination (default/convenience). Provide copy of any Cure Notices or Show Cause Letters received and describe any corrective action(s) implemented by the Offeror or subcontractor: _____________________________________________________________________________________

(i) Safety record (Use the number reported on OSHA Form No. 200 or equivalent):

Injuries with Lost Workdays __________ Injuries without Lost Workdays _________

Explain any injuries that occurred and corrective action(s) taken: ________________________________

(j) List and explain any customer concerns or dissatisfaction. Explain how you responded: ___________

(k) Small Business Subcontracting Effort (Complete for Offeror/Prime Contractor only):