Att 3 Past Performance List of References.pdf

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Attached to
PRK Clinic Services Federal contract opportunity
Solicitation number
FA301620R0058
Issued by
Department of the Air Force Air Education and Training Command

About this file

This solicitation seeks proposals for photorefractive keratectomy (PRK) clinical services to be provided at the Wilford Hall Ambulatory Surgical Center and Joint Warfighter Refractive Surgery Center on Joint Base San Antonio-Lackland Air Force Base. The Department of Defense requires fourteen full-time equivalent clinical and support personnel over a five-year ordering period from October 2020 to September 2025. Services include two optometrists, a clinical management research assistant, three surgical technicians, seven PRK clinic technicians, and an operations manager. Offerors must demonstrate relevant past performance and experience through references and questionnaires. The performance work statement, pricing worksheet, and instructions to offerors provide additional details on the required services, pricing, and proposal submission requirements.

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Text version

Attachment 3- Past Performance List of References

FA301620R0058

PAST PERFORMANCE LIST OF REFERENCES

Company Name:________________________________

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. )

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 BY A

PROPOSED

SUBCONTRACTOR

AFFILIATE, OR

JOINT VENTURE?

(If yes, please complete Page 2)

Total: $

Annual: $

POP for Annual:

Attachment 3- Past Performance List of References

FA301620R0058

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)

1.

2.

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