Attachment 2 - Past Performance Information Form (PPIF).docx
DOCX document 25 KB Posted
- Attached to
- PAD Medical Coders and Transcription Services
- Solicitation number
- HT001424R0004
- Issued by
-
Defense Health Agency
About this file
This document is a template for a Past Performance Information Form (PPIF) to be completed by offerors responding to solicitation number HT001424R0004 for PAD Medical Coders and Transcription Services issued by the Defense Health Agency. The PPIF requests information on up to three recent and relevant contracts, including customer details, period of performance, total contract price, subcontracting details if applicable, and points of contact. Offerors must provide a separate completed form for each contract cited as relevant past performance to demonstrate their ability to perform the required medical coding and transcription services.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP Q and A 11-29-23.pdf | ||
| Attachment 5 - Price Proposal Workbook rvsd.xlsx | XLSX spreadsheet | |
| HT001424R0004 PAD Medical Coders Solicitation.pdf | ||
| Attachment 4 - Past Performance Questionnaire.docx | DOCX document | |
| Attachment 1 - Performance Work Statement.pdf | ||
| Attachment 3 - Past Performance Recipient List.docx | DOCX document | |
| Attachment 5 - Price Proposal Workbook.xlsx | XLSX spreadsheet |
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Text version
HT001424R0004
Attachment 2
PRESENT AND PAST PERFORMANCE INFORMATION FORM (PPIF)
Provide the information requested in this form for each of the present or past contracts you have identified as recent and relevant to this solicitation. Provide a separate completed form for each contract identified.
A. Current Offeror (Company/Division):
Cage Code:
DUNS Number:
Additional Information: (If Present/Past Performance is for major subcontractor, please provide Company Name of subcontractor and annotate on this block as Subcontractor.)
B. Program Title:
C. Contract Specifics
1. Customer Name:
2. Customer Address and Phone No.
3. Contract Number and all applicable Order Numbers (i.e. Task Order, Delivery, Order, etc.):
4. Type of Contract
5. Period of Performance
| 6. Total Contract Price/Cost |
| $ |
| 7. Annual Contract Price/Cost |
| $ |
D. Description of Effort as Prime or Subcontractor
E. Describe how the work under this contract relates to this requirement. Please reference PWS paragraph reference when appropriate.
F. Self-assessment of past performance record. Provide information of any problems encountered and your corrective actions.
G. Current Status of Contract
H. Primary customer points of contact.
POINTS OF CONTACT
| Program Manager |
| Contracting Officer |
| Admin Contracting Officer |
Name:
Office:
Address:
Phone:
E-Mail:
Other (specify)::
Name:
Office:
Address:
Phone:
E-Mail:
I. Include below relevant information concerning compliance with FAR 52.219-8, Utilization of Small Business Concerns, under the cited earlier contract.
J. Subcontracting Plan Requirements
1. Was subcontracting Plan required?
2. Planned goal %
3. Achieved goal%
4. Explain why any goals were not met.
File details come from the government source that posted it. Updated .