ATTACHMENT 5 - SAMPLE QUESTIONNAIRE COVER LETTER.docx
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- Solicitation number
- W81K0426RA011
- Issued by
-
Department of the Army Medical Command
About this file
This is a sample questionnaire cover letter template for past performance evaluation in support of a competitive source selection for Psychological Health Support Services. The letter is addressed to references cited by offerors in their proposals for solicitation W81K0426RA011, requesting assessment of the offeror's performance on recent and relevant federal, state, local government, or commercial contracts comparable to NAICS 621330 (Offices of Mental Health Practitioners, except Physicians). Respondents must complete and return the enclosed questionnaire to the U.S. Army Health Contracting Activity, Health Readiness Contracting Office at Joint Base San Antonio, Fort Sam Houston, Texas, within 15 days of receipt or by a specified date, whichever occurs first. Submissions should be directed to Contract Specialist Alexis V. Medrano (alexis.v.medrano.civ@army.mil) and Contracting Officer Darlene M. Riley (darlene.m.riley.civ@army.mil). This template is intended to be completed on the company letterhead of the offeror and serves as the official request for past performance references during the Army's competitive evaluation process for the Psychological Health Program FY26 solicitation.
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ATTACHMENT 5 - SAMPLE QUESTIONNAIRE COVER LETTER
W81K04-26-R-A011
(This Should Be On Company Letterhead)
| To: | Questionnaire Evaluator | Date of Letter |
| Agency or Organization Name | ||
| Street Address | ||
| City/State/Zip Code |
| From: | Company Name (SAM UEI Number) |
| Street Address | |
| City/State/Zip |
Subject: Offeror Past Performance Assessment In Support Of Solicitation Number W81K0425RA011 for the Psychological Health Support Services
Dear Sir/Ma’am, The U.S. Army Health Contracting Activity, Health Readiness Contracting Office is currently conducting a competitive source selection to evaluate offerors on the subject solicitation for the Psychological Health Support Services. As part of this evaluation, we have requested that the Offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to North American Industry Classification System 621330, Offices of Mental Health Practitioners (except Physicians), you have been identified as the point of contact cited on the enclosure.
Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the U.S. Army Health Contracting Activity, Health Readiness Contracting Office, 2199 Storage Street Building, 4197, Suite 68, Joint Base San Antonio, Fort Sam Houston, TX, 78234, no later than 15 days after receipt of request or (insert date), whichever occurs first. Submit your completed questionnaire to Alexis V. Medrano, Contract Specialist, at alexis.v.medrano.civ@army.mil and Darlene Riley, Contracting Officer, darlene.m.riley.civ@army.mil.
Your cooperation is greatly appreciated. Questions may be directed to the Contract Specialists and Contracting Officer via email.
Sincerely,
| Signature |
| Printed Name, Title |
| Entity Name |
| SAM UEI Number |
| Phone Number / Email Address |
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