Attachment 2 - Past Performance References.pdf

129 KB Posted

Attached to
Video Magnification Device (CCTV Follow-On)
Solicitation number
36C10G26R0016
Issued by

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Written by GovTribe AI ·

This is a Past Performance References template form used for federal contract proposals to document an offeror's previous work experience and performance history.

The form provides space for offerors to list up to three past performance references, with each reference requiring detailed information about prior contract work. For each reference, offerors must identify the offeror name, the company that performed the work, and the relationship to the offeror (whether the offeror was the prime contractor or a proposed subcontractor, and whether the work was performed as a prime or subcontractor). Additional required information includes the name of the contracting organization, contract or task order number, contract type, total awarded price and final/projected final cost, delivery dates and period of performance including base and option periods, and contact information for both the contracting officer and program manager. Offerors must also provide the relevant North American Industry Classification System (NAICS) code and indicate whether a CPARS/PPIRS (Contractor Performance Assessment Reporting System/Past Performance Information Retrieval System) report was completed. Each reference requires a concise description of the work performed and its relevance to the current solicitation's requirements, as well as an explanation of any performance issues or problems that occurred, corrective actions taken, and results achieved. The form includes a checkbox option to indicate "No record of relevant or recent past performance" if applicable.

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Other files

File Type Posted
36C10G26R0016 0001.docx DOCX document
Attachment 3 - Past Performance Questionnaire.pdf PDF
36C10G26R0016.docx DOCX document
Attachment 5 - Pay.gov Vendor Submittal Instructions.pdf PDF
Attachment 8 - RFP Questions.xlsx XLSX spreadsheet
Attachment 4 - Contractor Discrepancy Report.pdf PDF
Attachment 1 - Pricing Schedule.xlsx XLSX spreadsheet
Attachment 9 - Sample HIPAA Business Associate Agreement.doc DOC document
Attachment 7 - Cross Reference Index.xlsx XLSX spreadsheet
Attachment 6 - QSR Reporting Tool.xlsx XLSX spreadsheet

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PAST PERFORMANCE REFERENCES

No record of relevant or recent past performance Past Performance Reference # 1

OFFEROR NAME:

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and Telephone Number:

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.

Past Performance Reference # 2

OFFEROR NAME:

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report

Past Performance Reference # 3

OFFEROR NAME:

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and

Program Manager's Name, Email, and

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report

Past Performance Reference 1:
OFFEROR NAME:
COMPANY who performed this work:
OFFEROR: Off
PROPOSED SUBCONTRACTOR: Off
PRIME: Off
SUBCONTRACTOR: Off
PRIME SUBCONTRACTORName of Contracting Organization:
PRIME SUBCONTRACTORContract Task Order Number for subcontracts provide the prime contract number and the subcontract number:
PRIME SUBCONTRACTORContract Type:
PRIME SUBCONTRACTORTotal Awarded PriceCost:
PRIME SUBCONTRACTORFinal or Projected Final Total PriceCost:
PRIME SUBCONTRACTORDelivery datePeriod of performance including base and options if applicable:
PRIME SUBCONTRACTORContracting Officers Name Email and Telephone Number:
PRIME SUBCONTRACTORProgram Managers Name Email and Telephone Number:
PRIME SUBCONTRACTORNorth American Industry Classification System NAICS Code:
CPARSPPIRS Completed:
undefined:
NO:
Description of the Requirement Provide a concise explanation of the work performed specifically related:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed:
OFFEROR NAME_2:
COMPANY who performed this work_2:
OFFEROR_2:
PROPOSED SUBCONTRACTOR_2:
undefined_2:
PRIME_2:
SUBCONTRACTOR_2:
Name of Contracting Organization:
Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number:
Contract Type:
Total Awarded PriceCost:
Final or Projected Final Total PriceCost:
Delivery datePeriod of performance including base and options if applicable:
Contracting Officers Name Email and Telephone Number:
Program Managers Name Email and Telephone Number:
North American Industry Classification System NAICS Code:
CPARSPPIRS Completed_2:
YES:
NO_2:
Description of the Requirement Provide a concise explanation of the work performed specifically related_2:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_2:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_2:
OFFEROR NAME_3:
COMPANY who performed this work_3:
OFFEROR_3:
PROPOSED SUBCONTRACTOR_3:
undefined_3:
PRIME_3:
SUBCONTRACTOR_3:
Name of Contracting Organization_2:
Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number_2:
Contract Type_2:
Total Awarded PriceCost_2:
Final or Projected Final Total PriceCost_2:
Delivery datePeriod of performance including base and options if applicable_2:
Contracting Officers Name Email and Telephone Number_2:
Program Managers Name Email and Telephone Number_2:
North American Industry Classification System NAICS Code_2:
CPARSPPIRS Completed_3:
YES_2:
NO_3:
Description of the Requirement Provide a concise explanation of the work performed specifically related_3:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_3:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_3:

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