D.3 PAST PERFORMANCE REFERENCES.rtf
RTF text file 227 KB Posted
- Attached to
- SPS Surgical Instrument Sharpening and Repair
- Solicitation number
- 36C25726Q0348
About this file
This is a Past Performance References form (Attachment 36C25726Q0348) that bidders must complete as part of their proposal submission for the SPS Surgical Instrument Sharpening and Repair solicitation with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17. The form is a template requiring contractors to provide three past performance references demonstrating their qualifications and experience.
Contractors must complete all three reference sections, each containing the following required information: name and address of the government or commercial organization served, relevant contract number, brief description of work performed, contractor's role (Prime Contractor or Sub-Contractor), dates of performance, total contract value, disclosure of any terminations for cause or default with explanations if applicable, notification of any contract discrepancy reports filed with explanations if applicable, and Point of Contact/Contracting Officer's Representative details including title, telephone number, and email address. Additional space is provided for comments on each reference. This form serves as documentation of the contractor's capability to perform comprehensive instrument maintenance services including on-site laser sharpening, refurbishment of Reusable Medical Devices, and off-site repairs, which are the core requirements of the solicitation.
Text of this file
D.3 ATTACHMENT 36C25726Q0348 – PAST PERFORMANCE REFERENCES
REFERENCE 1:
Name of Government or Commercial Organization: Address:
Contract Number:
Brief Description:
| Contractor Performed as (check one): Prime Contractor | Sub-Contractor | |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? 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 (check one): Prime Contractor | Sub-Contractor | |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? Circle YES or NO | |
| If yes, brief explanation: | Point Of Contact/COR: | |
| Title: | Telephone Number: |
Point of Contact’s email address:
Comments:
file_0.wmf
REFERENCE 3:
Name of Government or Commercial Organization: Address:
Contract Number:
Brief Description:
| Contractor Performed as (check one): Prime Contractor | Sub-Contractor | |
| Dates of Performance (if current include expiration): | Total Value of Contract: |
Any terminations for cause or default? Circle YES or NO
| If yes, brief explanation: | Any contract discrepancy reports filed? Circle YES or NO | |
| If yes, brief explanation: | Point Of Contact/COR: | |
| Title: | Telephone Number: |
Point of Contact’s email address:
Comments:
Other files
| File | Type | Posted |
|---|---|---|
| D.3 REVISED Container Product Details Totals (ALM-DP-NW-Kerrville).xlsx | XLSX spreadsheet | |
| S06 36C25726Q0348 0001_.docx | DOCX document | |
| D.1 REVISED Statement of Work.docx | DOCX document | |
| 36C25726Q0348_.pdf | ||
| D.2 Container Product Details Totals (ALM-DP-NW-Kerrville).xlsx | XLSX spreadsheet | |
| D.1 - STX SPS Instrument Sharpening SOW.docx | DOCX document |
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