INSTRUCTIONS FOR COMPLETING
CONTRACTOR PERFORMANCE STATEMENT
LANTDIV NORVA 4-7300/21 (NEW 1/98)
(Numbers in parenthesis correspond to the form)
Contract Number: The contract number as shown on the A/E contract. Include delivery/task order number
when invoicing for IDQ contracts. Include the contract (or delivery/task order) title and the location of work as
shown in on the A/E contract (delivery/task order).
Sheet Number(s): Self explanatory.
Period Ending: Closing date of work for which the invoice is presented. The closing date must agree with the
date on which the work was actually completed, i.e., the date on which submittals were actually delivered to
EFA CHES. In the case of engineering services contracts, supporting payroll data shall agree with this date.
Contract Action Number: This number represents the actual contract action; i.e., Award, Modification,
Contract Delivery/Task Order or Modification to Contract Delivery/Task Order as shown on the actual
Description of Line Item Services: The line items displayed in this column should correspond to the line items
identified in the contract action(s). The exact list of work items shall be approved by the AIC/EIC/PIC
prior to the first invoice submission.
A separate Contractor Performance Statement shall further detail all the services required by the contract line
item; e.g., engineering services shall be further broken down to identify field investigation, soil borings,
survey/plotting, rendering, etc. (link required to second sample)
Total Contract Action Cost: The dollar amount of negotiated line item(s). The amount negotiated for the item
in column 2, including overhead and profit.
Percentage Complete: The percentage of completed work including the work being invoiced:.
Value of Completed Performance: The total dollar amount of completed work including the work being
Prior Report: The total dollar amount paid prior to this Invoice
Current Report: The total dollar amount being request under this invoice.
ACRN: The first two letters show on the line of accounting and appropriations found on the award documents
(SF 252 Block 9; SF 30 Block 12; DD1155 Block 17). If multiple lines of accounting are used, show all
acrn's under the action.