D.3 PAST PERFORMANCE REFERENCES.rtf
RTF text file 229 KB Posted
- Attached to
- North Texas Hospital Patient Porters
- Solicitation number
- 36C25726Q0551
About this file
This is a Past Performance References form template (Attachment 36C25726Q0551) required for submission in response to Solicitation 36C25726Q0551 for North Texas Hospital Patient Porters services with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17. The form is a standard evaluation document and does not address specific products or services required; rather, it serves as an appendix for bidders to provide evidence of their relevant past performance on government and commercial contracts.
The template requires contractors to submit three past performance references, with each reference requesting the organization name and address, contract number, brief description of work performed, prime or sub-contractor designation, performance dates, total contract value, and any terminations for cause or default. Additionally, contractors must disclose whether contract discrepancy reports were filed and provide points of contact information including the Government/Contracting Officer's Representative name, title, telephone number, and email address, along with optional comments regarding contract performance. This documentation enables the contracting officer to assess contractor capability and past performance reliability during the evaluation process.
Text of this file
D.3 ATTACHMENT 36C25726Q0551 – 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:
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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 |
|---|---|---|
| 36C25726Q0551 0001_.pdf | ||
| D.1 WD 2015-5253 rev 29.pdf | ||
| RFQ 36C25726Q0551 .docx | DOCX document | |
| D.2 - Past Performance Survey.docx | DOCX document |
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