Past-Present_Performance_Questionnaire.docx
DOCX document 20 KB Posted
- Attached to
- HIPAA Privacy and Security Policy Services Federal contract opportunity
- Solicitation number
- 2015-Q-17159
About this file
Past Performance
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions.pdf | ||
| Relevant_Contracts_Reference_Sheet.docx | DOCX document | |
| Solicitation_2015-Q-17159.pdf | ||
| PWS_HIPAA_05.04.15.pdf | ||
| ACH-Vendor.pdf | ||
| HHSA_Security_Compliance.docx | DOCX document | |
| Supplemental_Instructions.pdf | ||
| QASP.pdf | ||
| Client_Authorization_Letter.docx | DOCX document |
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Text version
PAST/PRESENT PERFORMANCE QUESTIONNAIRE (PPQ)
WHEN COMPLETED THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor’s Name & Address:
Telephone Number:
Fax Number:
Point of Contact:
B. Contractor Cage Code:
C. Contract number:
D. Contract type:
E. Was this a competitive contract?
F. Period of performance:
G. Initial contract cost:
H. Current/final contract cost:
I. Reasons for differences between initial contract cost and final contract:
J. Description of service provided:
SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION
A. Customer or agency name:
B. Customer or agency description (if applicable):
C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:
SECTION 3: EVALUATOR IDENTIFICATION
A. Evaluator's name:
B. Evaluator's title:
C. Evaluator's phone/fax number:
D. Length of time (number of years/months) evaluator worked on subject contract:
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