ATTACHMENT A LIST OF PAST PERFORMANCE REFERENCES.docx
DOCX document 17 KB Posted
- Attached to
- Medication Dispensing Cabinets service agreement
- Solicitation number
- 36C25626Q1299
About this file
This is a past performance references template form for solicitation 36C25626Q1299, a Medication Dispensing Cabinets service agreement issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. The template is designed to collect contractor references demonstrating relevant past performance experience.
The form requires submission of three past performance references, with each reference requiring the following information: contracting activity name, location, contract number, point of contact name and telephone number, dollar amount, and a brief description of services provided. This template serves as an appendix to the solicitation and does not contain specific requirements, pricing terms, or other substantive solicitation details. Contractors must complete this form as part of their proposal submission to demonstrate their capability and experience in providing medication dispensing cabinet services or related work.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25627P0028_1.pdf | ||
| S06-36C25626Q1299 0001.pdf | ||
| 36C25626Q1299_1.pdf | ||
| ATTACHMENT D NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx | DOCX document | |
| ATTACHMENT E QASP.docx | DOCX document | |
| ATTACHMENT C CONTRACTOR CERTIFICATION.docx | DOCX document | |
| Attachment B Past Performance Questionaire fillable.pdf | ||
| ATTACHMENT F JA_OVER_SAT revised_Redacted.pdf |
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Text version
ATTACHMENT A – LIST OF PAST PERFORMANCE REFERENCES
36C25626Q1299
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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