Past Performance Worksheet.xlsx

XLSX spreadsheet 17 KB Posted

Attached to
J012--Fire Alarm & Fire Protection System Maintenance
Solicitation number
36C24127Q0055
Issued by

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This is a Past Performance Worksheet template designed to document contractor experience on relevant federal contracts. The worksheet provides space for bidders to submit detailed information on up to three past performance references (REF #1, REF #2, and REF #3), each containing standard evaluation criteria. For each reference, contractors must provide the contracting activity name and agency, contract number, award date, contract period (beginning and completion dates), total contract value, contract type, technical and contracting points of contact with full details (name, title, address, telephone, and email), place of performance, detailed description of work performed, any commendations or awards received, and a list of major subcontractors.

The worksheet is intended for use in the Department of Veterans Affairs' solicitation 36C24127Q0055 for Fire Alarm & Fire Protection System Maintenance services at the VA Medical Center Providence. This RFQ seeks comprehensive fire protection and alarm system maintenance services, classified under NAICS code 561621 (Security Systems Services) with a small business size standard of $25.0M and FSC/PSC J012 (Maintenance/Repair/Rebuild of Fire Control Equipment). Contractors responding to this solicitation are expected to complete this worksheet to demonstrate relevant past performance on similar preventative maintenance and fire protection contracts, which will be evaluated as part of the source selection process.

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Other files

File Type Posted
36C24127Q0055.docx DOCX document
LOS certification.pdf PDF
WD 2015-4083 - RI Rev35.pdf PDF
SOW Fire Alarm Protection.pdf PDF
WD 2015-4063 - NB Rev36.pdf PDF

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REF #1

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization: Preventative Maintenance, Department of Veterans Affiars
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

REF #2

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization:
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

REF #3

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization:
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

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