Attachment G - Past Performance References.pdf

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Attached to
Durable Medical Equipment Services
Solicitation number
36C25626Q0301
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About this file

This is a Past Performance References template requiring contractors to provide three reference contracts demonstrating their previous experience and capability. Each reference section requests the name and address of the government or commercial organization, contract number, and a brief description of the work performed. Contractors must indicate whether they served as a prime contractor or sub-contractor, provide the performance dates (including expiration dates for current contracts), and list the total contract cost along with any awards, incentives, or deductions received. The template requires disclosure of any terminations for cause or default, with explanation if applicable. For each reference, contractors must supply the Point of Contact or Contracting Officer's Representative (COR) information, including title, telephone number, and email address, along with space for additional comments regarding the contractor's performance. The form is structured to allow evaluators to verify contractor experience and assess past performance quality through direct communication with previous government and commercial clients.

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ATTACHMENT G - PAST PERFORMANCE REFERENCES

REFERENCE 1:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 2:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 3:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

File details come from the government source that posted it. Updated .