2.4.1-A0006_Attachment 2 - Past Performanceand Experience Form_Red-Line.docx
DOCX document 52 KB Posted
- Attached to
- ICE TELERADIOLOGY SERVICES
- Solicitation number
- 70CDCR26R00000016
- Issued by
-
Immigration and Customs Enforcement
About this file
This is a Past Performance and Experience Form template for the ICE Teleradiology Services solicitation (70CDCR26R00000016). The form requires offerors to submit detailed information on up to four past performance contract references, with each reference requiring specific contract data including title of effort, government or commercial contracting activity designation, point of contact information, company name/UEI/CAGE code, prime or subcontractor status, contract/task order numbers, contract type, award date, period of performance, total contract value, number of facilities supported and locations, full-time employees (FTEs) or X-rays performed, annual imaging volume, and labor categories performed. Offerors may also submit past performance information for predecessor, affiliate, or parent companies but must explain the relationship to the primary offering entity. At least one contract reference must be for work performed by the prime, joint venture, or collaborative team arrangement partner rather than a parent company, affiliate, or subcontractor.
The form additionally requires offerors to provide descriptions of work scope, responsibilities, and explanations demonstrating how each contract reference is recent, relevant, and valid to the Performance Work Statement requirements, along with clear articulation of the offeror's exact contribution to each effort. Two experience discussion items require narrative responses addressing teleradiology services experience in government, correctional, or detention facility settings (including unique challenges and Authority to Operate requirements) and experience managing high volumes of radiology reads across multiple imaging modalities in remote settings, including specific volumes, complexity of cases handled, and strategies or tools implemented to ensure timely and accurate interpretations. Offerors are prohibited from revising contract reference information columns, adding rows, changing font size, or otherwise manipulating the document format, though row heights may be adjusted as necessary to accommodate offeror responses.
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Text version
ATTACHMENT 25 – PAST PERFORMANCE AND EXPERIENCE FORM
INSTRUCTIONS
This is a cover page and does not count against the page limitations. Offeror input is prohibited on the cover page. Offerors shall provide responses to all items in the below tables in the “Offeror Response” columns ONLY. Offerors shall not revise the information in the “Contract Reference Required Information” columns, add rows to the tables, change the font size, or make any other changes or manipulate this document in any fashion. However, offerors may change the height of the rows if needed to ensure the offeror’s response properly fits in the designated space. Note, the government will NOT re-manipulate the row height to ensure the offeror’s entire response is visible. It is incumbent on the offeror to ensure their entire response is properly displayed.
[END OF COVER PAGE]
[THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK]
Contract Reference #1
| Contract Reference Required Information |
| Offeror Response |
Title of Effort
Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.
Name, UEI, and CAGE code of company who performed the effort
Was performance as a Prime or Subcontractor?
Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number
BPA Call/Task Order (TO)/Delivery Order (DO) Number
Contract Type (Firm Fixed Price, Labor Hour, Time & Material, etc.)
Date of Award
Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.
Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.
Number of facilities supported and locations.full time employees (FTEs) working on the contract or number of X-Rays performed.
Annual Imaging VolumeLabor Categories (LCATs) performed under the effort.
Contract Reference #1 – Predecessor , Affiliate, or Parent Company Explanation Contract Reference Required Information As noted in the RFP, offeror’s may also submit past performance information for predecessor, affiliate, or parent companies. Offerors must explain the difference between the primary offering entity and the predecessor, affiliate, or parent company when submitting past performance information for predecessor, affiliate, or parent companies.
Offeror Response
Contract Reference #1 - Description of Effort
Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.
Offeror Response
Contract Reference #2
| Contract Reference Required Information |
| Offeror Response |
Title of Effort
Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.
Name, UEI, and CAGE code of company who performed the effort
Was performance as a Prime or Subcontractor?
Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number
BPA Call/Task Order (TO)/Delivery Order (DO) Number
Contract Type
Date of Award
Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.
Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.
Number facilities supported and locationsof full time employees (FTEs) working on the contract or number of X-Rays performed.
Annual Imaging VolumeLabor Categories (LCATs) performed under the effort.
Contract Reference #2 – Predecessor, Affiliate, or Parent Company Explanation
As noted in the RFP, offeror’s may also submit past performance information for predecessor, affiliate, or parent companies. Offerors must explain the difference between the primary offering entity and the predecessor, affiliate, or parent company when submitting past performance information for predecessor, affiliate, or parent companies.
Offeror Response
Contract Reference #2 - Description of Effort
Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.
Offeror Response
Contract Reference #3
| Contract Reference Required Information |
| Offeror Response |
Title of Effort
Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.
Name, UEI, and CAGE code of company who performed the effort
Was performance as a Prime or Subcontractor?
Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number
BPA Call/Task Order (TO)/Delivery Order (DO) Number
Contract Type
Date of Award
Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.
Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.
Number of facilities supported and locations full time employees (FTEs) working on the contract or number of X-Rays performed.
Annual Imaging Volume Labor Categories (LCATs) performed under the effort.
Contract Reference #3 – Predecessor, Affiliate, or Parent Company Explanation
As noted in the RFP, offeror’s may also submit past performance information for predecessor, affiliate, or parent companies. Offerors must explain the difference between the primary offering entity and the predecessor, affiliate, or parent company when submitting past performance information for predecessor, affiliate, or parent companies.
Offeror Response
Contract Reference #3 - Description of Effort
Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.
Offeror Response
Contract Reference #4
| Contract Reference Required Information |
| Offeror Response |
Title of Effort
Government or commercial contracting activity Point of Contact (POC), telephone number, and email. Note, the government may send a Past Performance Questionnaire to the customer POC listed for each reference. As such, offerors are encouraged to ensure they submit the most up-to-date customer contact information.
Name, UEI, and CAGE code of company who performed the effort
Was performance as a Prime or Subcontractor?
Contract/Purchase Order (PO)/Blanket Purchase Agreement (BPA)/Indefinite Delivery Indefinite Quantity (IDIQ) Number
BPA Call/Task Order (TO)/Delivery Order (DO) Number
Contract Type
Date of Award
Period of Performance Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the performance period for the duration of the subcontractor effort or the BPA Call/TO/DO.
Total Value of Contract Inclusive of All Options If the effort was performed as a subcontractor or at a BPA Call/TO/DO level, provide the applicable dollar value of the work performed as opposed to a total contract/ceiling value.
Number of facilities supported and locationsfull time employees (FTEs) working on the contract or number of X-Rays performed.
Annual Imaging VolumeLabor Categories (LCATs) performed under the effort.
Contract Reference #4 – Predecessor, Affiliate, or Parent Company Explanation
As noted in the RFP, offeror’s may also submit past performance information for predecessor, affiliate, or parent companies. Offerors must explain the difference between the primary offering entity and the predecessor, affiliate, or parent company when submitting past performance information for predecessor, affiliate, or parent companies.
Offeror Response
Contract Reference #4 - Description of Effort
Description of work, scope, and responsibilities of the offeror along with, and brief explanation of how the contract reference is recent, relevant (similar in scope and magnitude to the PWS requirements), and valid. Offerors shall provide a clear explanation of their exact contribution to the effort for each Past Performance contract reference. As a reminder, at least one of the contract references submitted must be for work performed by the Prime, JV, or CTA partner, i.e. not a parent company, affiliate, subcontractor etc.
Offeror Response
Experience Discussion Item 1
Describe your experience providing teleradiology services for government, correctional, or detention facilities. What unique challenges did you encounter in these settings, and how did you address them? Additionally, did the contract require an Authority to Operate (ATO)? If so, how was this requirement met?
Offeror Response
Experience Discussion Item 2
Describe your experience managing high volumes of radiology reads across various imaging modalities (e.g., X-ray, CT, MRI, ultrasound) in a remote setting. What strategies, tools, or workflows have you implemented to ensure timely and accurate interpretations under heavy workload conditions? Please specify the volume and complexity of cases handled.
Offeror Response
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