Attachment A - Experience - Past Performance.doc

DOC document 45 KB Posted

Attached to
6505-- Pharmaceutical Repackaging and Distribution Services Federal contract opportunity
Solicitation number
36E79722R0003
Issued by
Department of Veterans Affairs National Acquisition Center

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Other files attached to 6505-- Pharmaceutical Repackaging and Distribution Services, newest first.
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36E79722R0003 0001.docx DOCX document
Attachment C - VA Crisis cap.pdf PDF
Attachment B - Myhealthevet - URL.pdf PDF
Attachment D - Product List.xls XLS spreadsheet
36E79722R0003_1.docx DOCX document
Attachment F - Small Business Subcontracting Plan.docx DOCX document
Attachment E - Wage Determination 2015-5017.pdf PDF

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ATTACHMENT “A”

EXPERIENCE - PAST PERFORMANCE

Please provide the following information for each of your current and completed commercial and/or Federal Government contracts for the period 10/01/2011 – 9/30/2016 of comparable size, depth, breadth, relevancy and complexity to the requirements of this solicitation. This form may be duplicated to list all relevant contracts.

Offeror: ___________________________________________

Number of years as a repackager: ___________________

Warehouse Size: ________________________________

1. Customer Name and Address:

Customer Contact Person: _______________________ Telephone Number_________________

E-mail Address: _________________________________

2. Information About the Contract:

Contract Number: _____ ______ Contract Period: ____________________

Estimated Annual Value of Contract: __________________________

Number of delivery (“ship to”) locations: _______________________

ATTACHMENT “A”

EXPERIENCE - PAST PERFORMANCE cont.

Description of Customer Contract Requirements/Scope/Services (per contract):

Note: VA reserves the right to verify information provided or to request additional information.

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