2.2.1-Attachment 2 - Past Performanceand Experience Form v4.docx

DOCX document 48 KB Posted

Attached to
ICE TELERADIOLOGY SERVICES
Solicitation number
70CDCR26R00000016
Issued by

About this file

This is a Past Performance and Experience Form template for offerors responding to the ICE Teleradiology Services solicitation (70CDCR26R00000016). The form requires offerors to submit four contract references demonstrating relevant past performance, with detailed information for each reference including title of effort, point of contact information, company details (name, UEI, CAGE code), prime or subcontractor status, contract/purchase order numbers, contract type, award date, period of performance, total contract value, full-time employee count, and labor categories performed. For predecessor companies, offerors must explain the relationship between the primary offering entity and the predecessor company when submitting their past performance information.

The form mandates that at least one contract reference must represent work performed by the Prime, Joint Venture, or Contractor Teaming Arrangement (CTA) partner—not a parent company, affiliate, or subcontractor. Offerors must provide clear descriptions of work scope, responsibilities, and their exact contributions for each reference, explaining how each contract demonstrates recent, relevant experience similar in scope and magnitude to the Performance Work Statement requirements. Additionally, offerors must address two experience discussion items: (1) their experience providing teleradiology services for government, correctional, or detention facilities, including unique challenges encountered and Authority to Operate (ATO) requirements; and (2) their experience managing high-volume radiology reads across multiple imaging modalities in remote settings, including specific strategies, tools, workflows, and case volume/complexity details. The form prohibits offerors from revising contract reference information columns, adding rows, or manipulating the document format, though row height adjustments are permitted to ensure proper content display.

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2.4.1-A0005_70CDCR26R00000016_RFP Sections B-M_Red-Line.pdf PDF
2.4.1-A0005_70CDCR26R00000016_RFP Sections B-M_Clean.pdf PDF
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ATTACHMENT 5 – PAST PERFORMANCE AND EXPERIENCE FORM

INSTRUCTIONS

This is a cover page and does not count against the page limitations. Offeror input is prohibited on the cover page. Offerors shall provide responses to all items in the below tables in the “Offeror Response” columns ONLY. Offerors shall not revise the information in the “Contract Reference Required Information” columns, add rows to the tables, change the font size, or make any other changes or manipulate this document in any fashion. However, offerors may change the height of the rows if needed to ensure the offeror’s response properly fits in the designated space. Note, the government will NOT re-manipulate the row height to ensure the offeror’s entire response is visible. It is incumbent on the offeror to ensure their entire response is properly displayed.

[END OF COVER PAGE]

[THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK]

Contract Reference #1

Contract Reference Required Information
Offeror Response

Title of Effort

Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.

Name, UEI, and CAGE code of company who performed the effort

Was performance as a Prime or Subcontractor?

Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number

BPA Call/Task Order (TO)/Delivery Order (DO) Number

Contract Type (Firm Fixed Price, Labor Hour, Time & Material, etc.)

Date of Award

Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.

Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.

Number of full time employees (FTEs) working on the contract or number of X-Rays performed.

Labor Categories (LCATs) performed under the effort.

Contract Reference #1 – Predecessor Company Explanation Contract Reference Required Information As noted in the RFP, offeror’s may also submit past performance information for predecessor companies. Offerors must explain the difference between the primary offering entity and the predecessor company when submitting past performance information for predecessor companies.

Offeror Response

Contract Reference #1 - Description of Effort

Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.

Offeror Response

Contract Reference #2

Contract Reference Required Information
Offeror Response

Title of Effort

Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.

Name, UEI, and CAGE code of company who performed the effort

Was performance as a Prime or Subcontractor?

Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number

BPA Call/Task Order (TO)/Delivery Order (DO) Number

Contract Type

Date of Award

Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.

Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.

Number of full time employees (FTEs) working on the contract or number of X-Rays performed.

Labor Categories (LCATs) performed under the effort.

Contract Reference #2 – Predecessor Company Explanation

As noted in the RFP, offeror’s may also submit past performance information for predecessor companies. Offerors must explain the difference between the primary offering entity and the predecessor company when submitting past performance information for predecessor companies.

Offeror Response

Contract Reference #2 - Description of Effort

Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.

Offeror Response

Contract Reference #3

Contract Reference Required Information
Offeror Response

Title of Effort

Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.

Name, UEI, and CAGE code of company who performed the effort

Was performance as a Prime or Subcontractor?

Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number

BPA Call/Task Order (TO)/Delivery Order (DO) Number

Contract Type

Date of Award

Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.

Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.

Number of full time employees (FTEs) working on the contract or number of X-Rays performed.

Labor Categories (LCATs) performed under the effort.

Contract Reference #3 – Predecessor Company Explanation

As noted in the RFP, offeror’s may also submit past performance information for predecessor companies. Offerors must explain the difference between the primary offering entity and the predecessor company when submitting past performance information for predecessor companies.

Offeror Response

Contract Reference #3 - Description of Effort

Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.

Offeror Response

Contract Reference #4

Contract Reference Required Information
Offeror Response

Title of Effort

Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.

Name, UEI, and CAGE code of company who performed the effort

Was performance as a Prime or Subcontractor?

Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number

BPA Call/Task Order (TO)/Delivery Order (DO) Number

Contract Type

Date of Award

Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.

Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.

Number of full time employees (FTEs) working on the contract or number of X-Rays performed.

Labor Categories (LCATs) performed under the effort.

Contract Reference #4 – Predecessor Company Explanation

As noted in the RFP, offeror’s may also submit past performance information for predecessor companies. Offerors must explain the difference between the primary offering entity and the predecessor company when submitting past performance information for predecessor companies.

Offeror Response

Contract Reference #4 - Description of Effort

Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.

Offeror Response

Experience Discussion Item 1

Describe your experience providing teleradiology services for government, correctional, or detention facilities. What unique challenges did you encounter in these settings, and how did you address them? Additionally, did the contract require an Authority to Operate (ATO)? If so, how was this requirement met?

Offeror Response

Experience Discussion Item 2

Describe your experience managing high volumes of radiology reads across various imaging modalities (e.g., X-ray, CT, MRI, ultrasound) in a remote setting. What strategies, tools, or workflows have you implemented to ensure timely and accurate interpretations under heavy workload conditions? Please specify the volume and complexity of cases handled.

Offeror Response

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