ATTACHMENT 4 PAST PERFORMANCE REFERENCES.docx

This is a Past Performance References template that solicitors must complete as part of their response to the Request for Quotation (RFQ) 36C26026Q0204 for Acute Bedside Dialysis Services. The template requires contractors to provide three verified past performance references, each documenting relevant contract experience. For each reference, contractors must supply the contract or task order title, point of contact name and title, contracting agency address and contact information, contract number, period of performance, contract value, and a description of the relevant work performed. The instruction emphasizes that all contact information must be current and verified to ensure the Government can conduct effective past performance evaluations.

This attachment supports the VA's Acute Bedside Dialysis Services procurement for the Boise VA Medical Center. The underlying solicitation is a five-year IDIQ contract with a guaranteed minimum quantity of 200 units and a maximum of 2,000 units, designated as a Veteran-Owned Small Business (VOSB) set-aside under NAICS code 621492 with a small business size standard of $47 million. Contractors responding to this RFQ must demonstrate capability through comprehensive quotation submissions, which include completion of this past performance reference form to establish their qualifications and track record in providing similar services.