Attachment 3 - Reference Sheet.pdf
PDF 316 KB Posted
- Attached to
- EKG Machines (35) - Travis AFB, CA Federal contract opportunity
- Solicitation number
- FA442720R0039
About this file
This document contains a past performance reference sheet for a federal contractor and details of a related federal contract opportunity posted by the Department of the Air Force Air Mobility Command. The reference sheet requests information on three past performance examples including contract period of performance, contracting agency points of contact, contract values, and notes whether work was performed by any proposed subcontractors or joint ventures. The federal contract opportunity is a sole source solicitation for 35 EKG machines from the vendor SCImage to equip David Grant Medical Center at Travis AFB, CA. The machines must be ELI380 models from SCImage and have the capability to interface with the base's cardiology PACS system and the new MHS Genesis electronic medical records system.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Solicitation Amendment - FA442720R00390001 SF 30.pdf | ||
| Attachment 2 - Technical Evaluation Factors.pdf | ||
| Solicitation Amendment - FA442720R00390001.pdf | ||
| Attachment 1 - Statement of Work.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment 3 - List of References
PAST PERFORMANCE LIST OF REFERENCES
Vendor Name:
CONTRACT NUMBER
(include task order number(s) if applicable)
DESCRIPTION OF WORK PERFORMED
(performed as a prime/sub-contractor, details i.e.
number of FTE, position type, full-time or session-based, %performed, etc. )
CONTRACT
PERIOD OF
PERFORMANCE
(POP)
CONTRACTING AGENCY
POC/CUSTOMER NAME, PHONE #
CONTRACT VALUES
(include total contract amount, annual amount and POP for annual amount)
PERFORMED BY A
PROPOSED
SUBCONTRACTOR
AFFILIATE, OR
JOINT VENTURE?
(If yes, please complete Page 2)
Total: $
Annual: $
POP for Annual:
Total: $
Annual: $
POP for Annual:
Total: $
Annual: $
POP for Annual:
CONTRACT NUMBER
(include task order number(s) if applicable)
SUBCONTRACTOR,
AFFILIATE, OR
JOINT VENTURE
DESCRIBE FUNCTION/TASK/3RD PARTY AFFECT ON PERFORMANCE
1. If proposing to use a Subcontractor, Affiliate, or Joint Venture for this effort, include percentage of work, splitting of cost, type of services i.e. accounting, recruiting, etc they will perform for this effort (provide information below)
2. If contractor proposing on this effort provided past performance they performed as a Subcontractor, Affiliate, or Joint Venture, include percentage of work, splitting of cost, type of services performed, i.e. accounting, recruiting, etc for that effort (provide information below)
1.
2.
1.
2.
1.
2.
Attachment 3 - List of References
File details come from the government source that posted it. Updated .