Attachment 1 Past Performance Information.pdf
PDF 451 KB Posted
- Attached to
- Audio Booth for Galesburg Iowa CBOC
- Solicitation number
- 36C26323Q1221
About this file
This document contains a past performance questionnaire for federal contractors and a description of a related federal contract opportunity. The past performance questionnaire requests information on two most recent and relevant contracts, including contract numbers, types, buying offices, descriptions of efforts, original and completion values, performance periods, and space to address technical concerns. The related federal contract opportunity is a solicitation from the Department of Veterans Affairs for an audio booth for the Galesburg, Iowa Community Based Outpatient Clinic, identified as solicitation number 36C26323Q1221. Offerors are requested to provide the past performance questionnaire with their bid, proposal, or quotation for the audio booth contract.
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| File | Type | Posted |
|---|---|---|
| S02 36C26323Q1221 IC Audio Booth Galesburg CBOC.pdf |
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Text version
PRESENT AND PAST PERFORMANCE QUESTIONNAIRE
A. PLEASE PROVIDE TWO (2) PAST AND/OR PRESENT PERFORMANCE REFERENCES FOR THE MOST
RECENT, RELEVANT CONTRACTS. PLEASE RETURN THIS PACKAGE WITH YOUR
BID/PROPOSAL/QUOTATION. *Note: offeror may include this same information in the text block of their proposal submission email if preferred rather than sending a scanned copy of this form*
OFFEROR’S/BIDDER’S NAME (Company/Division): _________________________________________________
JOB 1
1. CONTRACT NUMBER: ________________________________ 2. TYPE: ____________________________
3. BUYING OFFICE:
a. Address: _________________________________________________________________________________
b. Phone: __________________________________________________________________________________
c. Contracting Officer/Point of Contact: __________________________________________________________
4. BRIEF DESCRIPTION OF EFFORT: ____________________________________________________________
5. CONTRACT $ VALUE: a. Original: _________________________________________________________
b. Value at Completion: _______________________________________________
c. Reason for any Change: _____________________________________________
6. PERFORMANCE PERIOD: a. Date Completed/To Be Completed: ____________________________________
b. Reason for Any Change: ____________________________________________
7. USE THIS SPACE TO ADDRESS ANY TECHNICAL (OR OTHER) AREA OF CONCERN CONSIDERED
UNIQUE: _____________________________________________________________________________________
Attachment 1: Past Performance Information
OFFEROR’S/BIDDER’S NAME (Company/Division): _________________________________________________
JOB 2
1. CONTRACT NUMBER: ________________________________ 2. TYPE: ____________________________
3. BUYING OFFICE:
a. Address: _________________________________________________________________________________
b. Phone: ___________________________________________________________________________________
c. Contracting Officer/Point of Contact: ___________________________________________________________
4. BRIEF DESCRIPTION OF EFFORT: ____________________________________________________________
5. CONTRACT $ VALUE: a. Original: _________________________________________________________
b. Value at Completion: _______________________________________________
c. Reason for any Change: _____________________________________________
6. PERFORMANCE PERIOD: a. Date Completed/To Be Completed: ____________________________________
b. Reason for Any Change: ____________________________________________
7. USE THIS SPACE TO ADDRESS ANY TECHNICAL (OR OTHER) AREA OF CONCERN CONSIDERED
UNIQUE: _____________________________________________________________________________________
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