36C24420Q0407-004.docx
DOCX document Posted
- Attached to
- Q999--Multiple Site DME (VA-20-00009700) Federal contract opportunity
- Solicitation number
- 36C24420Q0407
About this file
This document contains a past performance template for vendors to provide when responding to solicitation number 36C24420Q0407 from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4. The template requests information on up to five customers for which the vendor has provided services in the past year, including the customer name, point of contact, phone number, and services provided. Relevant services should first be listed for any VA medical centers, then other federal government facilities, then commercial customers. The solicitation seeks multiple site durable medical equipment with responses due by April 7, 2020 according to the number listed. Pricing, terms, and further requirements are not specified in this template, which is to be completed as an attachment by vendors when bidding on the opportunity.
36C24420Q0407 Attachment 3-Past Performance information.docx
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Other files for this federal contract opportunity
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| 36C24420Q0407-0001000.docx | DOCX document | |
| 36C24420Q0407-007.docx | DOCX document | |
| 36C24420Q0407-003.docx | DOCX document | |
| 36C24420Q0407-001.docx | DOCX document | |
| 36C24420Q0407-011.pdf | ||
| 36C24420Q0407-010.pdf | ||
| 36C24420Q0407-006.docx | DOCX document | |
| 36C24420Q0407-002.docx | DOCX document | |
| 36C24420Q0407-012.xlsx | XLSX spreadsheet | |
| 36C24420Q0407-008.pdf | ||
| 36C24420Q0407-005.docx | DOCX document | |
| 36C24420Q0407-009.pdf |
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Text version
ATTACHMENT #3
PAST PERFORMANCE
Complete the following past performance information for your Department of Veterans Affairs (VA) customers. Past Performance information submitted should be for VA Medical Centers that have procured services in the past year. If your company has not sold services to VA(s), include information for customers. First, provide information for any VA(s), then, information for sales to other federal government facilities (Department of Defense, Public Health, Bureau of Prisons, etc.), then, commercial customers.
1. Customer Name: __________________________________________________________ Point of Contact: __________________________________________________________ Phone Number: __________________________________________________________ Service(s) Provided: __________________________________________________________
2. Customer Name: __________________________________________________________ Point of Contact: __________________________________________________________ Phone Number: __________________________________________________________ Service(s) Provided: __________________________________________________________
3. Customer Name: __________________________________________________________ Point of Contact: __________________________________________________________ Phone Number: __________________________________________________________ Service(s) Provided: __________________________________________________________
4. Customer Name: __________________________________________________________ Point of Contact: __________________________________________________________ Phone Number: __________________________________________________________ Service(s) Provided: __________________________________________________________
5. Customer Name: __________________________________________________________ Point of Contact: __________________________________________________________ Phone Number: __________________________________________________________ Service(s) Provided: __________________________________________________________
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