5-Past Present.pdf

138 KB Posted

Attached to
Narcan Vending Machine and Naloxboxes Implementation and Maintenance
Solicitation number
RFP-RC-2026-006
Issued by
Rockland County, New York

About this file

Written by GovTribe AI ·

This is a Past & Present Performance Information Form submitted by an offeror to the Rockland County Department of Mental Health (RCDMH) in New York for the Narcan Vending Machine and Naloxboxes Implementation and Maintenance contract opportunity (RFP-RC-2026-006). The form requests documentation of the offeror's relevant past performance and experience on similar contracts or programs. The RCDMH seeks qualified organizations, preferably non-profit entities, to establish, implement, operate, and maintain a minimum of four Narcan vending machines and up to 20 Naloxbox emergency kits throughout Rockland County, along with a public website displaying Narcan availability locations. This three-year contract aims to improve public access to FDA-approved Naloxone products as a harm reduction strategy to combat the opioid crisis. The contract is intended to be awarded by April 1, 2026, with all machine and kit locations requiring pre-approval by RCDMH.

The form requires offerors to provide comprehensive details regarding their relevant past contract performance, including the contracting entity name, original and current contract values, contract term dates, change order information with primary causes, and key personnel who will support the proposed effort. Offerors must identify whether they served as prime or subcontractor on previous projects and provide subcontractor names with corresponding percentage allocations. The form mandates current contact information for primary customer points of contact, including reference program/project managers and contracting officers, to enable verification of past performance and organizational capability. This documentation serves as a technical proposal component to demonstrate the offeror's qualifications and experience in implementing similar programs.

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Other files

File Type Posted
4-RFP-RC-2026-006- Narcan Vending Machines.pdf PDF
6-FEDERAL CONTRACT CLAUSE.pdf PDF
1-Appendix B Standard Terms Conditions for Service Contracts.pdf PDF
2-RFP-RC-2026-006 Budget Table Multi-Year.xlsx XLSX spreadsheet
7-Addendum 1.pdf PDF
3-Statement of Disclosures.pdf PDF

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Edwin J. Day, County Executive

PAST & PRESENT PERFORMANCE INFORMATION FORM

COMPLETE AND INCLUDE THIS FORM IN YOUR TECHNICAL PROPOSAL

NAME OF OFFEROR: __________________________________

Provide the information requested on this form for each contract/program being described as a reference. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations, if any, set forth in specifications.

Name of Contracting Entity: ___________________________________ Contract Name/Title: __________________________________

Term of Contract: ____________________________

Original Contract Value: ________________________________ Current or Final Contract Value: _______________________________________

A. Brief Description of your effort. Identify whether you were a Prime or Subcontractor.

1. Original Date: ______________________________ 2. Current or Final Date: __________________________

3. Number of Change Orders (if any): ________________

Primary Causes or Reasons of Change: ________________________________________________________________________

B. Primary Customer Points of Contact:

NOTE: CONFIRM CONTACT INFORMATION PROVIDED IS CURRENT PRIOR TO SUBMISSION.

Reference Program/Project Manager:

Name:______________________________________________________

Address:____________________________________________________

Telephone: ______________________ Fax: _______________________

E-mail: _____________________________________________________

Reference Contracting Officer

Name:__________________________________________________

Address: _______________________________________________

Telephone: ___________________ Fax: ___________________

E-mail: _________________________________________________

C. If subcontractors were used, identify the names of the subcontractors and the percentage of the contract the subcontractor was responsible for. ____________________________________________________________________________________________

D. Specify, by name, any key individual(s) who participated in this contract and are proposed to support acquisition detailed in the RFP.

Narcan Vending Machine and Naloxboxes Implementation and Maintenance RFP-RC-2026-006

MoodieC Highlight

NAME OF OFFEROR:
Name of Contracting Entity:
Contract Name/Title:
Term of Contract:
Original Contract Value:
Current or Final Contract Value:
A:
1 Original Date:
3 Number of Change Orders (if any):
Primary Causes or Reasons of Change:
Primary Causes or Reasons of Change_1:
2 Current or Final Date:
2 Current or Final Date_1:
responsible for:
D:
D_1:
Name:
Address:
Telephone:
Fax:
E-mail:
Name_1:
Address_1:
Telephone_1:
Fax_1:
E-mail_1:

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