10 - Past Performance References Form for VA_REV. Nov 23.pdf
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- Solicitation number
- 36C10F26R0052
About this file
This is a Past Performance List of References Form for the Department of Veterans Affairs (REV. 11/23), serving as a template for offerors to document their relevant contract experience during the proposal submission process.
The form requires offerors to provide solicitation information including the RLP number, offer due date and time, VA contracting officer and broker contact details, and the offeror entity name. Offerors must then list up to five past performance references, providing contract reference numbers, past performance contractor entity names and UEI numbers, reference contact names/titles and phone/email information. For each reference, offerors must indicate the PPQ (Past Performance Questionnaire) status by selecting one of three options: (A) if using a previously completed PPQ for a VA contract, (B) if a PPQ request was submitted to the reference contact (with submission date required), or (C) if the contract is non-VA. This form enables VA evaluators to assess offeror qualifications and performance history as part of the competitive proposal evaluation process, with specific submission instructions referenced in Section 4.04 of the relevant RLP (Request for Logistics Proposal or similar procurement document).
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Text version
Past Performance List of References
Past Performance List of References Form for VA (REV. 11/23)
Solicitation Information
RLP No.:
Offers Due By (Date/Time):
VA Contracting Officer (Name/Email):
VA Broker (Name/Email):
Offeror Entity Name:
PAST PERFORMANCE LIST OF REFERENCES
In reference to column PPQ below, check the appropriate box (see RLP, Section 4.04, for submission instructions):
A. Select A if VA Contract, Offeror using a previously completed PPQ B. Select B if VA Contract, Offeror submitted a PPQ request to the reference contact; include date of submission C. Select C if Non-VA Contract
Contract Reference
No.
Past Performance Contractor Entity Past Performance Reference PPQ Date PPQ Submitted to
Reference Entity Name UEI No. Name/Title Phone/Email
1 A B C
2 A B C
3 A B C
4 A B C
5 A B C
File details come from the government source that posted it. Updated .