Attachment 6 - Past Performance Reference Template - Dental Network.pdf
PDF 155 KB Posted
- Attached to
- Q503--CCN Next Gen - Dental Network
- Solicitation number
- 36C10G26R0004
About this file
This document is a Past Performance References template for federal contract proposals, specifically Attachment 6. It provides a standardized form for offerors to document up to three relevant past performance references demonstrating their experience and capability to perform the solicitation's requirements.
Each of the three reference sections requires offerors to identify the contracting organization, contract/task order number, contract type, awarded and final prices, performance period, and contracting officer and program manager contact information. Offerors must specify the NAICS code, indicate whether CPARS/PPIRS performance reports were completed, and provide a concise explanation of the work performed with specific relevance to the current solicitation's requirements. Additionally, each reference section includes a Performance field where offerors must explain any performance issues or problems that occurred, describe corrective actions taken, and detail expected or realized results from those actions. Any issues documented in CPARS or PPIRS reports for the referenced contracts must be addressed in this section. The template allows offerors to indicate the relationship of the work performer to the offeror (whether the offeror performed the work directly or through a proposed subcontractor) and the role (prime or subcontractor). An optional checkbox at the beginning permits offerors to indicate if there is no record of relevant or recent past performance.
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ATTACHMENT 6: PAST PERFORMANCE REFERENCES
No record of relevant or recent past performance Past Performance Reference # 1
OFFEROR NAME:
COMPANY who performed this work:
Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR
WORK PERFORMED AS THE: PRIME SUBCONTRACTOR
Name of Contracting Organization:
Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):
Contract Type:
Total Awarded Price/Cost:
Final or Projected Final Total Price/Cost:
Delivery date/Period of performance (including base and options if applicable):
Contracting Officer's Name, Email, and Telephone Number:
Program Manager's Name, Email, and Telephone Number:
North American Industry Classification System (NAICS) Code:
CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.
Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.
Past Performance Reference # 2
OFFEROR NAME:
COMPANY who performed this work:
Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR
WORK PERFORMED AS THE: PRIME SUBCONTRACTOR
Name of Contracting Organization:
Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):
Contract Type:
Total Awarded Price/Cost:
Final or Projected Final Total Price/Cost:
Delivery date/Period of performance (including base and options if applicable):
Contracting Officer's Name, Email, and Telephone Number:
Program Manager's Name, Email, and
North American Industry Classification System (NAICS) Code:
CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related
Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report
Past Performance Reference # 3
OFFEROR NAME:
COMPANY who performed this work:
Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR
WORK PERFORMED AS THE: PRIME SUBCONTRACTOR
Name of Contracting Organization:
Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):
Contract Type:
Total Awarded Price/Cost:
Final or Projected Final Total Price/Cost:
Delivery date/Period of performance (including base and options if applicable):
Contracting Officer's Name, Email, and
Program Manager's Name, Email, and
North American Industry Classification System (NAICS) Code:
CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related
Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report
| Past Performance Reference 1: |
| OFFEROR NAME: |
| COMPANY who performed this work: |
| OFFEROR: Off |
| PROPOSED SUBCONTRACTOR: Off |
| PRIME: Off |
| SUBCONTRACTOR: Off |
| PRIME SUBCONTRACTORName of Contracting Organization: |
| PRIME SUBCONTRACTORContract Task Order Number for subcontracts provide the prime contract number and the subcontract number: |
| PRIME SUBCONTRACTORContract Type: |
| PRIME SUBCONTRACTORTotal Awarded PriceCost: |
| PRIME SUBCONTRACTORFinal or Projected Final Total PriceCost: |
| PRIME SUBCONTRACTORDelivery datePeriod of performance including base and options if applicable: |
| PRIME SUBCONTRACTORContracting Officers Name Email and Telephone Number: |
| PRIME SUBCONTRACTORProgram Managers Name Email and Telephone Number: |
| PRIME SUBCONTRACTORNorth American Industry Classification System NAICS Code: |
| CPARSPPIRS Completed: |
| undefined: |
| NO: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements: |
| Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed: |
| OFFEROR NAME_2: |
| COMPANY who performed this work_2: |
| OFFEROR_2: |
| PROPOSED SUBCONTRACTOR_2: |
| undefined_2: |
| PRIME_2: |
| SUBCONTRACTOR_2: |
| Name of Contracting Organization: |
| Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number: |
| Contract Type: |
| Total Awarded PriceCost: |
| Final or Projected Final Total PriceCost: |
| Delivery datePeriod of performance including base and options if applicable: |
| Contracting Officers Name Email and Telephone Number: |
| Program Managers Name Email and Telephone Number: |
| North American Industry Classification System NAICS Code: |
| CPARSPPIRS Completed_2: |
| YES: |
| NO_2: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related_2: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_2: |
| Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_2: |
| OFFEROR NAME_3: |
| COMPANY who performed this work_3: |
| OFFEROR_3: |
| PROPOSED SUBCONTRACTOR_3: |
| undefined_3: |
| PRIME_3: |
| SUBCONTRACTOR_3: |
| Name of Contracting Organization_2: |
| Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number_2: |
| Contract Type_2: |
| Total Awarded PriceCost_2: |
| Final or Projected Final Total PriceCost_2: |
| Delivery datePeriod of performance including base and options if applicable_2: |
| Contracting Officers Name Email and Telephone Number_2: |
| Program Managers Name Email and Telephone Number_2: |
| North American Industry Classification System NAICS Code_2: |
| CPARSPPIRS Completed_3: |
| YES_2: |
| NO_3: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related_3: |
| Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_3: |
| Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_3: |
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