10 RLP 36C10F26R0024 Past Performance List of References SPB County FL OPC 7_17_ 2026.pdf
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- Solicitation number
- 36C10F26R0024
About this file
This is a Past Performance List of References form for VA (Veteran Affairs) contracts, revised November 2023. The form is used by offerors responding to solicitation RLP No. 36C10F26R0024 for South Palm Beach County, FL OPC, with offers due by 09/18/2026. The VA Contracting Officer is Cynthia White (cynthia.white6@va.gov) and the VA Broker is Patricia Restrepo (patricia.restrepo@chartwellenterprises.com).
The form requires offerors to provide up to five past performance references and classify each according to its contract type and Past Performance Questionnaire (PPQ) status. For each reference, offerors must identify the contract reference number, past performance contractor entity name and UEI number, reference contact name/title with phone/email, and select one of three PPQ options: (A) VA Contract using a previously completed PPQ, (B) VA Contract with PPQ request submitted to reference contact (including submission date), or (C) Non-VA Contract. Submission instructions are referenced in RLP Section 4.04.
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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
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| 0: 36C10F26R0024 - South Palm Beach County, FL OPC |
| 1: Cynthia White cynthia.white6@va.gov |
| 2: Patricia Restrepo patricia.restrepo@chartwellenterprises.com |
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Date7_af_date: 09/18/2026
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