ATTACHMENT F_PAST PERFORMANCE REFERENCE_NX EQ TEE SCANNING SYSTEMS.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C10X27R0011
About this file
This is a Past Performance Reference form template for the NX EQ Transesophageal Echocardiography (TEE) Scanning Systems solicitation (36C10X27R0011) issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick. The document notes at the outset that there is "no record of relevant or recent past performance" for the offeror. The form provides three blank reference sections for offerors to complete, with each section requiring documentation of prior contract performance related to the solicitation requirements.
Each past performance reference requires the offeror to provide the following information: company name, relationship to offeror (prime or subcontractor), role on contract, contracting organization name, contract or task order number, contract type, total awarded price and final/projected final price, delivery date and period of performance, contracting officer and program manager contact details, NAICS code, CPARS/PPIRS completion status, a description of work performed and its relevance to current solicitation requirements, and an explanation of any performance issues encountered along with corrective actions taken and results achieved. The form explicitly requires that any performance issues documented in CPARS/PPIRS reports must be addressed in the submission.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT E_REPORTING TOOL_NX EQ TEE SCANNING SYSTEMS.xlsx | XLSX spreadsheet | |
| S02 36C10X27R0011 Combined Synopsis Solicitation.docx | DOCX document | |
| ATTACHMENT B_CONTRACT ADMINISTRATION_NX EQ TEE SCANNING SYSTEMS.docx | DOCX document | |
| ATTACHMENT J_CERTIFICATION OF RECALL OR SAFETY ISSUES_NX EQ TEE SCANNING SYSTEMS.docx | DOCX document | |
| ATTACHMENT G_PAST PERFORMANCE QUESTIONNAIRE_NX EQ TEE SCANNING SYSTEMS.docx | DOCX document | |
| ATTACHMENT C_CONTRACT CLAUSES_NX EQ TEE SCANNING SYSTEMS.docx | DOCX document | |
| ATTACHMENT D_SOLICITATION PROVISIONS_NX EQ TEE SCANNING SYSTEMS.docx | DOCX document | |
| ATTACHMENT H_RFQ QUESTIONS_NX EQ TEE SCANNING SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT A_PRICE COST SCHEDULE_NX EQ TEE SCANNING SYSTEMS.xlsx | XLSX spreadsheet |
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Text version
ATTACHMENT F: PAST PERFORMANCE REFERENCE
NX EQ TEE SCANNING SYSTEMS
SOLICITATION: 36C10X27R0011
☐ No record of relevant or recent past performance.
Past Performance Reference # 1
OFFEROR NAME:
COMPANY who performed this work:
| Relationship to Offeror: |
| ☐ OFFEROR ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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:
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 ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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:
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 # 3
OFFEROR NAME:
COMPANY who performed this work:
| Relationship to Offeror: |
| ☐ OFFEROR ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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:
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.
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