Attachment_05_-_Past_Performance_Information_Summary(Parts_A_&_B).doc

Section J, Attachment 5

W91RUS-17-R-0006

PAST PERFORMANCE INFORMATION SUMMARY

PART A

The Offeror shall provide a list of all references requested to submit Past Performance Questionnaires on your company’s behalf. The Past Performance Reference List (PART A only) is due three (3) days before proposal due date, via email to joe.L.morris4.civ@mail.mil and cheryl.m.todd.civ@mail.mil. The Prime Offeror should provide at least 3, but no more than five 5 referenced contracts. For each major subcontractor/team member/joint venture, at least 2, but no more than 3 referenced contracts should be provided (each). The Offeror shall only provide the requested data in the columns below and utilize PART B for contract narratives. Any Past Performance narratives provided in this part will be excluded from evaluation.

LIST OF References:

Reference 1:

A. Referenced Company:

B. Questionnaire Point of Contact/e-mail:

C. Contractor's Name:

D. Contract Name:

E. Contract Number:

F. Mark an "X" next to tasks/functions performed under this referenced contract.

Reference 2:

A. Referenced Company:

B. Questionnaire Point of Contact/e-mail:

C. Contractor's Name:

D. Contract Name:

E. Contract Number:

F. Mark an "X" next to tasks/functions performed under this referenced contract.

Reference 3:

A. Referenced Company:

B. Questionnaire Point of Contact/e-mail:

C. Contractor's Name:

D. Contract Name:

E. Contract Number:

F. Mark an "X" next to tasks/functions performed under this referenced contract.

Reference 4:

A. Referenced Company:

B. Questionnaire Point of Contact/e-mail:

C. Contractor's Name:

D. Contract Name:

E. Contract Number:

F. Mark an "X" next to tasks/functions performed under this referenced contract.

Reference 5:

A. Referenced Company:

B. Questionnaire Point of Contact/e-mail:

C. Contractor's Name:

D. Contract Name:

E. Contract Number:

F. Mark an "X" next to tasks/functions performed under this referenced contract.

PAST PERFORMANCE INFORMATION SUMMARY INSTRUCTIONS

PART B

The Offeror shall provide the information requested in this template for each contract/program being identified as a reference. Please provide frank, concise comments regarding your performance on the contracts you identified. Provide a separate completed summary for each reference submitted. Limit the number of past efforts submitted and the length of each submission to the limitations set forth in Section L.6.1.e.

(NOTE: If the company or division performing this effort is different from the Offeror’s name provided in the proposal submission, or the relevance of this effort is impacted by a company/corporate organizational change, note those changes.)

a. Section 1 - Contract Description B.

SECTION 2 – Performance

1. Address any technical (or other) areas about this contract considered unique.

2. For each of the applicable sub-factors under the Mission Support Factor in Section L, illustrate how your experience on this contract applies to that sub-factor.

3. Describe any past or present litigation or administrative proceeding pertaining to the reference contract, including the results, if the proceedings are complete or the current status if the proceedings are ongoing. The Offeror shall also provide a copy of any cure notices or show-cause notices received on each contract listed and a description of any corrective action taken. The Offeror shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.

4. Discuss the number and severity of problems in the referenced contract and the effectiveness of corrective actions taken to resolve the problems.

C.

SECTION 3 -SUBCONTRACTORS:

1. Offerors shall provide the above required information for any proposed subcontractor on this effort.

D.

SECTION 4 - NEW ENTITY:

1. New corporate entities may submit data on prior contracts involving its officers and employees. However, in addition to the other requirements in this section, the Offeror shall discuss the role performed by such persons in the prior contracts cited.

NOTE: The Government reserves the right to contact and use information provided by the references and any other sources. It is the Offerors’ responsibility to ensure all reference data is current so that the performance information can be evaluated.

PAST PERFORMANCE INFORMATION SUMMARY

PART B

a. Section 1 - Contract Description:

1) OFFEROR'S NAME (Company/Division)

CAGE CODE:

DUNS NUMBER.

TAX I.D. NUMBER

2) PROGRAM TITLE

3) CONTRACT SPECIFIC:

Contracting Agency or Customer:

Contract Number:

Contract Type:

Place of Performance:

Period of Performance:

Original Contract $ Value:

(inclusive of base & all options)

Current Estimated Contract $ Amount:

(do not include unexercised options)

4) BRIEF DESCRIPTION of Effort as the _____ Prime or _____ Subcontractor:

(Please highlight portions considered most relevant to current acquisition.)

5) COMPLETION DATE:

Original Date:

Current Schedule:

Estimate as Completion:

How many Times Changed:

Primary Cause of Change:

6) PRIMARY CUSTOMER POINT(s) OF CONTACT:

a) Contracting Officer:

Name:

Office:

Address:

E-MAIL:

Telephone:

Fax:

b) Contracting Officer's Representative:

Name:

Office:

Address:

E-MAIL:

Telephone:

Fax:

b. SECTION 2 - Performance:

c. SECTION 3 -SUBCONTRACTORS:

d. SECTION 4 - NEW ENTITY: