ATTACHMENT 2 Experience Reporting Form.docx
DOCX document 18 KB Posted
- Attached to
- Psychological Health Program (PHP) FY26
- Solicitation number
- W81K0426RA011
- Issued by
-
Department of the Army Medical Command
About this file
This document is an Experience Reporting Form for a Sources Sought synopsis related to the Psychological Health Program (PHP) FY26 for the United States Army Reserve Command (USARC). The form requires potential contractors to provide detailed information about up to three projects demonstrating relevant experience in psychological health services completed within the previous 36 months.
The form captures comprehensive project details including firm name, contract number, location, contract type, pricing arrangement, work description, relevance to the acquisition, contractor role, contract amount, contract dates, and termination history. The associated federal contract opportunity is a pre-solicitation issued by the Army Health Care Activity, seeking to identify qualified vendors capable of supporting psychological health program requirements across the Continental United States (CONUS), with the Department of the Army Medical Command as the sponsoring agency.
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Other files
| File | Type | Posted |
|---|---|---|
| Request for Interest_Psych Health Program FY26 (25 NOV 25).pdf | ||
| ATTACHMENT 1 Market Research Questionnaire.docx | DOCX document | |
| ATTACHMENT 3 Questions and Answers.docx | DOCX document |
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Text version
Attachment 2 - SOURCES SOUGHT – PSYCHOLOGICAL HEALTH PROGRAM FY26
EXPERIENCE REPORTING FORM
EXPERIENCE REPORTING FORM
Provide the following information to show up to three (3) examples of projects each for your company and your teaming partner/subcontractor completed for a total of 24 months of the previous 36 months indicating experience with projects of same or similar type and scope to Psychological Health Program Services. Use one form per project.
Project No. 1
a. Name of Firm: _________________________
b. Contract Number, Title, and Location of Project: __________________
c. Contract Type and Pricing Arrangement: ______________
d. Type of Work/Description of the job:
e. Describe how the contract referenced is relevant to the immediate acquisition. If only portions of the contract are relevant, specify which portions of the contract are relevant to the immediate acquisition:
f. Role (Prime, Joint Venture, or Subcontractor, etc.): __________________________
g. Contract or Subcontract (Award) Amount:
h. Dates of Contract: Began: __________ Completed: ______________
i. Were You Terminated or Assessed Liquidated Damages? yes no. If “yes”, provide explanation:
Project No. 2
a. Name of Firm: ___________________________________
b. Contract Number, Title, and Location of Project: ____________________.
c. Contract Type and Pricing Arrangement: ________________
d. Type of Work/Description of the job:
e. Describe how the contract referenced is relevant to the immediate acquisition. If only portions of the contract are relevant, specify which portions of the contract are relevant to the immediate acquisition:
f. Role (Prime, Joint Venture, or Subcontractor, etc.): __________________ Services._________________________________
g. Contract or Subcontract (Award) Amount:
h. Dates of Contract: Began: __________ Completed: ______________
Project No. 3
a. Name of Firm: _____________
b. Contract Number, Title, and Location of Project: __________________
c. Contract Type and Pricing Arrangement: _________________________
d. Type of Work/Description of the job: ___________________________
e. Describe how the contract referenced is relevant to the immediate acquisition. If only portions of the contract are relevant, specify which portions of the contract are relevant to the immediate acquisition:
f. Role (Prime, Joint Venture, or Subcontractor, etc.): _______________________
g. Contract or Subcontract (Award) Amount: ______________________________
h. Dates of Contract: Began: __________Completed: ______________________
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