ATTACHMENT A LIST OF PAST PERF REF.docx

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Attached to
7220--Carpet and Luxury Vinyl Tile supplies
Solicitation number
36C25626Q0405
Issued by

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This is a past performance references template form for solicitation 36C25626Q0405. The document provides a standardized format for offerors to submit three past performance references demonstrating their experience with similar work. Each reference section requires the contracting activity name, location, contract number, point of contact information, telephone number, dollar amount, and a brief description of services provided. The template contains blank fields for offerors to populate with relevant contract history that substantiates their qualifications for the current requirement.

This attachment is part of a Request for Quotation issued by the Gulf Coast Veterans Health Care System (GCVHCS), Network Contracting Office 16 in Biloxi, Mississippi, for commercial-grade carpet and luxury vinyl tile supplies to support maintenance and renovation projects. The solicitation is a 100% set-aside for Service-Disabled Veteran Owned Small Businesses (SDVOSB) with a firm-fixed-price contract type, NAICS code 238330, and a closing date of March 6, 2026 at 12:00 PM CT. Offerors must be registered in the SAM database and provide supplies within 60 days of order placement. The requirement may necessitate offerors to demonstrate that at least 51 percent of personnel costs will be spent on SDVOSB employees.

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ATTACHMENT A – LIST OF PAST PERFORMANCE REFERENCES

36C25626Q0405

PAST PERFORMANCE REFERENCES

REFERENCE 1:

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

REFERENCE 2:

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

REFERENCE 3:

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

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