S02 - SOLICITATION ATTACHMENT - D.2 PAST PERFORMANCE REFERENCE INFORMATION.docx

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Q201--CBOC IN WATERTOWN, NY IN JEFFERSON COUNTY
Solicitation number
36C24219R0090
Issued by

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This document provides instructions for offerors to submit past performance references for a solicitation from the Department of Veterans Affairs for multi-specialty community-based outpatient clinic services in Watertown, New York. Offerors must provide at least three references for similar sized and scoped medical services delivered in the past three years. For each reference, the offeror must include the contract number, value, period of performance, agency or company name, current point of contact, and brief description demonstrating relevance. The point of contact for each reference must be able to provide performance feedback and include their name, title, phone number and email address. The solicitation seeks proposals to provide both primary and mental health care with two or more specialty services on site to veterans residing in Jefferson County, New York. Access to additional specialties may be offered through referral or telehealth.

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Text version

D.2 PAST PERFORMANCE REFERENCE INFORMATION

Offeror shall complete the listing of past performance references below, including at least three businesses or medical facilities of similar size and scope to this solicitation, that have purchased the offered services in the past three years. References listed must be familiar with the contract and able to answer questions about performance and adherence to requirements. The offeror is responsible for ensuring contact information for all past performance references is the most recent and valid information available.

For each past performance reference identified below, the offeror shall include the following information:

· Contract Number

· Contract Value

· Period of Performance

· Name of agency or company contract was with

· Current Point of Contact (including: name, title or position, phone number, and email address) who can provide performance feedback information

· Brief description of the contract demonstrating the relevance in scope to this requirement

Reference 1:

Contract Number

Contract Value

Period of Performance

Name of Agency/Company

Current Point of Contact

Name

Title/Position

Phone Number

Email Address

Brief Description of Contract

Reference 2:

Contract Number

Contract Value

Period of Performance

Name of Agency/Company

Current Point of Contact

Name

Title/Position

Phone Number

Email Address

Brief Description of Contract

Reference 3:

Contract Number

Contract Value

Period of Performance

Name of Agency/Company

Current Point of Contact

Name

Title/Position

Phone Number

Email Address

Brief Description of Contract

Reference 4:

Contract Number

Contract Value

Period of Performance

Name of Agency/Company

Current Point of Contact

Name

Title/Position

Phone Number

Email Address

Brief Description of Contract

Reference 5:

Contract Number

Contract Value

Period of Performance

Name of Agency/Company

Current Point of Contact

Name

Title/Position

Phone Number

Email Address

Brief Description of Contract

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