ATTACHMENT 5 LIST OF PAST PERFORMANCE REFERENCES.docx

DOCX document 17 KB Posted

Attached to
Q517--Pharmavy Benefit Management
Solicitation number
36C25625Q1538
Issued by

About this file

Attachment 5 is a Past Performance References template for a Pharmacy Benefit Management solicitation (36C25625Q1538) issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. The document provides a structured form for offerors to document three separate past performance references, with designated sections to capture critical contract details including contracting activity name, location, contract number, performance dates, point of contact, telephone number, dollar amount, and a brief description of services provided.

The template is designed to allow potential contractors to demonstrate their relevant experience and track record in delivering similar services, which will likely be evaluated as part of the solicitation's technical and past performance assessment. While the specific form is blank in this instance, it represents a standard federal procurement mechanism for collecting verifiable performance history from vendors competing for the Pharmacy Benefit Management contract.

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ATTACHMENT 5 – LIST OF PAST PERFORMANCE REFERENCES

PAST PERFORMANCE REFERENCES

REFERENCE 1:

Contracting Activity Name: _________________________________ Location: _____________________________________ Contract Number: ______________________________ Dates of performance _______________________ Point Of Contact: ______________________________ Telephone Number: ____________________________ Dollar Amount: __________________ Brief Description of Services Provided: _______________________________________

REFERENCE 2:

Contracting Activity Name:_________________________________ Location: _____________________________________ Contract Number: ______________________________ Dates of performance _______________________ Point Of Contact: ______________________________ Telephone Number: ____________________________ Dollar Amount: __________________ Brief Description of Services Provided: _______________________________________

REFERENCE 3:

Contracting Activity Name:_________________________________ Location: _____________________________________ Contract Number: ______________________________ Dates of performance _______________________ Point Of Contact: ______________________________ Telephone Number: ____________________________ Dollar Amount: __________________ Brief Description of Services Provided: _______________________________________

File details come from the government source that posted it. Updated .