Attachment 4 - Past Performance References.pdf
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- Attached to
- Solicitation - Therapeutic Medical Physicist & Medical Dosimetrist Support Services, Travis AFB, CA
- Solicitation number
- FA442724R0005
About this file
This document contains a past performance reference template for a federal solicitation from the Department of the Air Force Air Mobility Command. The template collects information on up to three past performance references including contract details, period of performance, contracting agency points of contact, contract values, and notes whether work was performed as a prime, subcontractor, affiliate, or joint venture. For any work performed as a subcontractor, affiliate, or joint venture, the template requests details such as percentage of work, cost split, and type of services provided. Eligible offerors are required to complete this template to submit with proposals for therapeutic medical physicist and medical dosimetrist support services at Travis Air Force Base in California. The solicitation number for this opportunity is FA442724R0005.
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Text version
Attachment 4
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:
Attachment 4
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.
File details come from the government source that posted it. Updated .