J.10 - PAST PERFORMANCE REPORT – SHORT FORM.docx

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Amendment 2 - Request for Proposals (RFP) No. 7200AA21R00009 Comprehensive Technical Assistance for Health Supply Chain and Pharmaceutical Management (Comprehensive TA)
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7200AA21R00009
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This document contains a federal contract opportunity solicitation and a past performance report short form template. The solicitation seeks proposals for Comprehensive Technical Assistance for Health Supply Chain and Pharmaceutical Management under the Next Generation Global Health Supply Chain Suite of Programs. The purpose is to strengthen systems and provide operational support to ensure sustainable access to safe, effective, quality-assured, affordable health commodities. This will include developing local capacity for sustainably managing supply chains and strengthening pharmaceutical management systems and regulatory systems. The agency is the US Agency for International Development Bureau for Management. Offerors must complete the past performance report short form template which requests information such as contract number, type, complexity, description and location of relevant past work, dollar value, dates of award and completion, subcontracting details, and references. The closing date is not provided.

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J.10 - PAST PERFORMANCE REPORT – SHORT FORM

The form is not required if the below information is available in the Government past performance systems.

(To be completed by the Offeror)

1. Contract Number:

2. Contractor (Name and Address):

3. Type of Contract: Negotiated Sealed Bid ____ Fixed Price ____ Cost Reimbursement _____ Hybrid (explain) _______________________

4. Complexity of Work: Difficult __Routine

5. Description, location, and relevancy of work:

6. Contract Dollar Value: _____ Status: Active Completed

7. Date of Award: _______________ Contract Completion Date (including extensions): ______________

8. Type and Extent of Subcontracting:

9. Name, Address, Telephone Number, and E-mail Address of the Procuring Contracting Officer and/or the Contracting Officer ’s Representative (and other references—e.g., Administrative Contracting Officer —if applicable):

[END OF PAST PERFORMANCE REPORT – SHORT FORM]

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