2022 PAST PERFORMANCE REFERENCES.pdf

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Annual Support and Maintenance for the STERRAD 100NX ECN: 031846, ECN: 031847
Solicitation number
W91YTZ22R0046
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Solicitation Released 09-09-2022.pdf PDF

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Gordon Health Contracting Branch Bldg 332, 43 Central Hospital Court Fort Gordon, GA 30905

PAST PERFORMANCE REFERENCES

To Be Completed By Offeror and returned directly to the Gordon Health Contracting Branch. Please e-mail completed form to Ms. Trina Wadley, Contract Specialist, trina.k.wadley.civ@health.mil or Francine Brown, Contracting Office, Francine.brown.civ@health.mil.

OFFEROR: _____________________________________________________________________

The following information refers to the organization with which you performed on a contract.

Referenced Company Name/Government Office _______________________________________

Referenced Company/Government Address _________________________________________

Reference Point of Contact ___________________________________ Phone/Fax___________

Referenced Person’s Role in contract effort __________________________________________

Contract Number ____________________ Description of Services _______________________

Number of Credentialed Ancillary Employees on Referenced Contract N/A_____________________

Number of Non-Credentialed Ancillary Employees on Referenced Contract N/A_________________

Contract Award Date _____________ Number of Options _______ Completion Date _________

Contract Type _______________________________________ Competed? ___ Yes ___ No

Initial Contract Value ____________________ Adjusted Value with Changes _______________

Reason for Changes _____________________________________________________________

Explain why you consider the services similar to the services required by this solicitation:

mailto:trina.k.wadley.civ@health.mil

Gordon Health Contracting Branch
Bldg 332, 43 Central Hospital Court
Fort Gordon, GA 30905
PAST PERFORMANCE REFERENCES
OFFEROR: _____________________________________________________________________
Referenced Person’s Role in contract effort __________________________________________
Contract Number ____________________ Description of Services _______________________
Number of Credentialed Ancillary Employees on Referenced Contract N/A_____________________
Number of Non-Credentialed Ancillary Employees on Referenced Contract N/A_________________
Initial Contract Value ____________________ Adjusted Value with Changes _______________
Reason for Changes _____________________________________________________________

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