Attachment 4: PAST PERFORMANCE INFORMATION FORM

Attachment (4)

PAST PERFORMANCE INFORMATION FORM

Form ___ of ___
Name of Offeror:

Contract Number, order number, or identifier:

Customer Name & Location:

Customer Point of Contact (Name & Title):

Telephone Number and e-mail address (PLEASE VERIFY):

Total dollar value for this effort including all growth work (definite and option items)

(Show either fiscal year or calendar year and dollars):

Period of Performance:
From:
To:
Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the scope of the solicitation:

Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts: