4. Past Performance List of References 2025 SB.pdf
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- Solicitation number
- FA301625Q6053
About this file
This document is a Past Performance List of References template for an Aerospace Medicine Physician (Flight Surgeon) contract solicitation. The template is designed for potential contractors to document their previous contract experiences, including contract numbers, work descriptions, performance periods, contract values, and agency contact information. The associated federal contract opportunity is for the Defense Language Institute at Lackland, Joint Base San Antonio, TX, seeking one Full Time Equivalent (FTE) Aerospace Medicine Specialist Physician for a base period of one year (1 April 2025 - 31 March 2026) with four additional one-year option periods extending through 31 March 2030. The solicitation is issued by the Department of the Air Force Air Education and Training Command under solicitation number FA301625Q6053, with contractors required to provide detailed past performance references demonstrating their qualifications for the aerospace medicine specialist role.
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Attachment 6 – Past Performance List of References
Aerospace Medicine Physician (Flight Surgeon) Sam.Gov FA301625Q6053
PAST PERFORMANCE LIST OF REFERENCES
Company Name:________________________________
CPARS
Y/N
CONTRACT NUMBER
(include task order number(s) if applicable)
DESCRIPTION OF WORK
PERFORMED
(performed as a prime/sub-contractor, details i.e. number of FTE, position type, full-time or session-based, %performed, etc. )
FTE
CONTRACT
PERIOD OF
PERFORMANCE
(POP)
CONTRACTING AGENCY POC/CUSTOMER
NAME, PHONE # & EMAIL
CONTRACT VALUES
(include total contract amount, annual amount and POP for annual amount)
PERFORMED AS A PROPOSED
SUBCONTRACTOR,
AFFILIATE, OR
JOINT VENTURE?
(If yes, please complete Page 2)
Total: $
Annual: $
POP for Annual:
Total: $
Annual: $
POP for Annual:
Total: $
Annual: $
POP for Annual:
Attachment 6 – Past Performance List of References Aerospace Medicine Physician (Flight Surgeon)
Sam.Gov FA301625Q6053
CONTRACT NUMBER
(include task order number(s) if applicable)
SUBCONTRACTOR,
AFFILIATE, OR
JOINT VENTURE
DESCRIBE FUNCTION/TASK/3RD PARTY AFFECT ON PERFORMANCE
1. If proposing to use a Subcontractor, Affiliate, or Joint Venture for this effort, include percentage of work, splitting of cost, type of services i.e. accounting, recruiting, etc they will perform for this effort (provide information below)
2. If contractor proposing on this effort provided past performance they performed as a Subcontractor, Affiliate, or Joint Venture, include percentage of work, splitting of cost, type of services performed, i.e. accounting, recruiting, etc for that effort (provide information below)
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