Attachment C - Past Performance References_0002.pdf
PDF 616 KB Posted
- Attached to
- R425 National VHA Biomedical Engineering Technical Professional Support Services (BETPSS) IDIQ
- Solicitation number
- 36C10X26R0010
About this file
This document is Attachment C: Past Performance References, a template form used by offerors to submit past performance information in federal contract proposals.
The form accommodates up to three past performance references, with each reference section requiring the offeror to identify the company that performed the work, specify whether it was the offeror itself or a proposed subcontractor, and indicate whether the work was performed as a prime or subcontractor. Required contract details include the contracting organization name, contract or task order number (with subcontract numbers for subcontracts), contract type, total awarded price/cost, final or projected final price/cost, delivery dates and performance periods including base and option periods, and the North American Industry Classification System (NAICS) code. Contact information must be provided for both the Contracting Officer and Program Manager, including names, email addresses, and telephone numbers. Each reference requires a concise description of work performed with specific relevance to the current solicitation's requirements, and a performance section addressing any issues or problems that occurred, corrective actions taken, and results achieved. The form also includes a checkbox to indicate whether a Contractor Performance Assessment Reporting System (CPARS) or Past Performance Information Retrieval System (PPIRS) report was completed, with instructions that any issues identified in such reports must be addressed in the response. An optional checkbox at the top allows offerors to indicate "No record of relevant or recent past performance" if applicable.
View the file
Other files
Show all 20
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
D.1 ATTACHMENT C: 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: |
File details come from the government source that posted it. Updated .