D.4 Reference Contract Worksheet - Nurse Staffing Services Experience.docx

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Q401--Veterans Affairs Loma Linda Healthcare System (VALLHS) Nurse Staffing Services Amendment 0003
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36C26223R0067
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D.4 Reference Contract Worksheet Demonstrating Nurse Staffing Services Experience

The information collected by this Worksheet will be used to evaluate proposals for STEP 1 of proposal evaluations. Offerors submitting proposals to provide nurse staffing services for this procurement must complete the below Table demonstrating that Offeror (or Offeror’s proposed subcontractor) has experience providing nursing staff in each of the nurse specialties required for this procurement and that Offeror (or Offeror’s proposed subcontractor) has provided these staffing services. Offerors are only required to provide one reference contract for each nursing specialty. Offerors must complete each Table entry.

Reference Contract Worksheet Demonstrating Offeror’s (or Offeror’s proposed subcontractor’s) Experience Providing Nurse Staffing Services

Nursing Specialty
Agency/Activity Where Services are/were Provided
Contract Number
Period of Performance
Point of contact (name, phone and email) for verification

Nurse Practitioner

Registered Nurse - General

Registered Nurse - Specialty

Licensed Vocational Nurse

Certified Nurse Assistant

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