Attach 3-Past Performance List of References.pdf
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- Solicitation number
- FA301020R0027
About this file
This document contains an attachment for a federal solicitation requesting past performance references from offerors. The solicitation seeks personal services for two full time equivalent Medical Laboratory Scientists/Medical Technologists, eight Medical Laboratory Technicians, and two Phlebotomists to provide laboratory services at the 81st Medical Group at Keesler Air Force Base in Mississippi. Offerors must provide three past performance references using the attachment, including contract details such as period of performance, contract values, contracting agency points of contact. For any work performed by subcontractors, affiliates, or joint ventures, offerors must describe the arrangement including the percentage and type of work performed.
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Attachment 3-List of References Solicitation #: FA301020R0027
Blood Donor Center
(2) Medical Technologists, (8) Medical Laboratory Technicians and
(2) Phlebotomist
PAST PERFORMANCE LIST OF REFERENCES
Company Name:________________________________
CONTRACT NUMBER
(include task order number(s) if applicable) Identify if CPAR is available.
If so, no PPQ is required.
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 #
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:
Total: $
Annual: $
POP for Annual:
Total: $
Annual: $
POP for Annual:
Attachment 3-List of References Solicitation #: FA301020R0029
Blood Donor Center
(2) Medical Technologists, (8) Medical Laboratory Technicians and
(2) Phlebotomist
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 .