Attachment 1- Past Performance Information Sheet.docx
DOCX document 18 KB Posted
- Attached to
- EMF KILO Conference Room Federal contract opportunity
- Solicitation number
- HT940624Q0083
- Issued by
- Defense Health Agency
About this file
This document is an Attachment 1 - Past Performance Information Sheet related to Solicitation HT940624Q0083 issued by the Defense Health Agency (DHA) Southeastern Healthcare Operations Division. The solicitation is for video conferencing equipment with installation service at the Naval Medical Center Camp Lejeune in North Carolina. The attachment requires the offeror to provide past performance information, including contract details, point of contact information, and a description of the services performed. If the offeror does not have any recent or relevant past performance, they must indicate that on the form. The solicitation is being competed as a Competitive 8(a) requirement, and the period of performance is through September 30, 2024. Quotes must be submitted electronically to the Contracting Officer by the date specified in the solicitation document.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| HT940624Q0083 0001- Amendment.pdf | ||
| RFQ HT940624Q0083.pdf | ||
| Attachment 3- Business Information Sheet.docx | DOCX document | |
| Attachment 2 - Pricing Sheet_HT940624Q0083.xlsx | XLSX spreadsheet | |
| Exhibit A- EMF-Kilo_ProjectPics _final.pdf | ||
| RFQ HT940624Q0083.pdf |
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Text version
Attachment 1 – Past Performance Information Sheet Past Performance Information Sheet
The Defense Health Agency (DHA) Southeastern Healthcare Operations Division is conducting an acquisition for the services noted below. The offeror has identified you as a reference to validate past performance.
Solicitation HT940624Q0083 is for non-personal services; Video Conferencing Equipment with Installation Service at the Naval Medical Center Camp Lejeune located in Camp Lejeune, NC.
· Include this form “Attachment 1- Past Performance Information Sheet” as part of Volume II: Past Performance.
· If the Offeror has no past performance, check “does not possess any recent or relevant past performance” on page 3 of this document.
· Attachment 1- Past Performance Information Sheet, must be signed and dated to be considered complete.
1- POC CONTRACT INFORMATION (to be completed by the Offeror):
Contracting Activity/Customer:
Point of Contact (POC):
Title of POC:
Telephone:
Email:
1- CONTRACT INFORMATION (to be completed by the Offeror):
Contract Number:
Task Order Number (if applicable):
Performance Period: (Base plus any options):
| Federal Government Contract: |
| Yes or No |
Description of Services (included position description(s)):
REQUIREMENT DESCRIPTION
Description of required:
Facility Type Services performed for (i.e., Hospital/Clinic):
2- POC CONTRACT INFORMATION (to be completed by the Offeror):
Contracting Activity/Customer:
Point of Contact (POC):
Title of POC:
Telephone:
Email:
2- CONTRACT INFORMATION (to be completed by the Offeror):
Contract Number:
Task Order Number (if applicable):
Performance Period: (Base plus any options):
| Federal Government Contract: |
| Yes or No |
Description of Services (included position description(s)):
REQUIREMENT DESCRIPTION
Description of required:
Facility Type Services performed for (i.e., Hospital/Clinic):
3- POC CONTRACT INFORMATION (to be completed by the Offeror):
Contracting Activity/Customer:
Point of Contact (POC):
Title of POC:
Telephone:
Email:
3- CONTRACT INFORMATION (to be completed by the Offeror):
Contract Number:
Task Order Number (if applicable):
Performance Period: (Base plus any options):
| Federal Government Contract: |
| Yes or No |
Description of Services (included position description(s)):
REQUIREMENT DESCRIPTION
Description of required:
Facility Type Services performed for (i.e., Hospital/Clinic):
____ Our company does not possess any recent or relevant past performance currently.
| _____________________ | ____________________ | _________________ | |
| Signature | Title | Date |
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