Attachment B - Past Performance References.pdf

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Attached to
TELERADIOLOGY PHYSICIAN SERVICES Federal contract opportunity
Solicitation number
36C10G26R0015
Issued by
Department of Veterans Affairs Headquarters

About this file

This document is a template for Past Performance References used in federal contract proposals. It provides a standardized form for offerors to document and submit up to four relevant past performance examples, whether as the prime contractor or proposed subcontractor. The template requires offerors to identify the company that performed the work, their relationship to the offeror, and the role performed (prime or subcontractor). For each reference, offerors must supply the contracting organization's name, contract or task order number (including prime contract and subcontract numbers for subcontracts), contract type, total awarded price/cost, final or projected final price/cost, delivery date and period of performance (including base and option periods), and contact information for the contracting officer and program manager. Additionally, offerors must provide the applicable North American Industry Classification System (NAICS) code and indicate whether a CPARS/PPIRS (Contractor Performance Assessment Reporting System/Past Performance Information Retrieval System) evaluation was completed.

The form requires offerors to provide a detailed description of the work performed and explain its relevance to the current solicitation's requirements. A separate section addresses performance issues, requiring offerors to document any problems that occurred, corrective actions taken, and results achieved through those corrective actions, with specific attention to any issues noted in CPARS/PPIRS reports. For proposed major subcontractors, offerors must explain the rationale for designating them as major to the contract effort. The template includes an option to indicate "No record of relevant or recent past performance" at the beginning, allowing offerors to acknowledge when they lack applicable experience for a particular reference category.

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Other files for this federal contract opportunity

Other files attached to TELERADIOLOGY PHYSICIAN SERVICES, newest first.
File Type Posted
Attachment F QASP.pdf PDF
Attachment A - PWS NTP Physician Services.pdf PDF
Attachment C - Past Performance Questionnaire.pdf PDF
36C10G26R0015 NTP PHYSICAN SERVICES.pdf PDF
Attachment D - Proposal Price Template.xlsx XLSX spreadsheet
Attachment E - Questions and Answers.xlsx XLSX spreadsheet

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ATTACHMENT A: PAST PERFORMANCE REFERENCES

No record of relevant or recent past performance Past Performance Reference # 1

OFFEROR NAME:

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and Telephone Number:

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.

For Proposed Major Subcontractors Only: Explain rationale why they will be considered a major subcontractor for this contract effort.

Past Performance Reference # 2

OFFEROR NAME:

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and Telephone Number:

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.

Past Performance Reference # 3

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and Telephone Number:

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.

Past Performance Reference # 4

COMPANY who performed this work:

Relationship to OFFEROR: OFFEROR PROPOSED SUBCONTRACTOR

WORK PERFORMED AS THE: PRIME SUBCONTRACTOR

Name of Contracting Organization:

Contract / Task Order Number (for subcontracts, provide the prime contract number and the subcontract number):

Contract Type:

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer's Name, Email, and Telephone Number:

Program Manager's Name, Email, and Telephone Number:

North American Industry Classification System (NAICS) Code:

CPARS/PPIRS Completed: YES NO Description of the Requirement: Provide a concise explanation of the work performed, specifically related

Performance: Explain any performance issues or problems that occurred, corrective actions taken, and any expected or realized results based on those corrective actions. Any issues discussed in a CPARS/PPIRS report for this reference are to be addressed.

Past Performance Reference 1:
OFFEROR NAME:
COMPANY who performed this work:
OFFEROR: Off
PROPOSED SUBCONTRACTOR: Off
PRIME: Off
SUBCONTRACTOR: Off
PRIME SUBCONTRACTORName of Contracting Organization:
PRIME SUBCONTRACTORContract Task Order Number for subcontracts provide the prime contract number and the subcontract number:
PRIME SUBCONTRACTORContract Type:
PRIME SUBCONTRACTORTotal Awarded PriceCost:
PRIME SUBCONTRACTORFinal or Projected Final Total PriceCost:
PRIME SUBCONTRACTORDelivery datePeriod of performance including base and options if applicable:
PRIME SUBCONTRACTORContracting Officers Name Email and Telephone Number:
PRIME SUBCONTRACTORProgram Managers Name Email and Telephone Number:
PRIME SUBCONTRACTORNorth American Industry Classification System NAICS Code:
CPARSPPIRS Completed:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed:
OFFEROR NAME_2:
COMPANY who performed this work_2:
Name of Contracting Organization:
Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number:
Contract Type:
Total Awarded PriceCost:
Final or Projected Final Total PriceCost:
Delivery datePeriod of performance including base and options if applicable:
Contracting Officers Name Email and Telephone Number:
Program Managers Name Email and Telephone Number:
North American Industry Classification System NAICS Code:
CPARSPPIRS Completed_2:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_2:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_2:
OFFEROR NAME_3:
COMPANY who performed this work_3:
Name of Contracting Organization_2:
Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number_2:
Contract Type_2:
Total Awarded PriceCost_2:
Final or Projected Final Total PriceCost_2:
Delivery datePeriod of performance including base and options if applicable_2:
Contracting Officers Name Email and Telephone Number_2:
Program Managers Name Email and Telephone Number_2:
North American Industry Classification System NAICS Code_2:
CPARSPPIRS Completed_3:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_3:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_3:
OFFEROR NAME_4:
COMPANY who performed this work_4:
Name of Contracting Organization_4:
Contract Task Order Number for subcontracts provide the prime contract number and the subcontract number_4:
Contract Type_4:
Total Awarded PriceCost_4:
Final or Projected Final Total PriceCost_4:
Delivery datePeriod of performance including base and options if applicable_4:
Contracting Officers Name Email and Telephone Number_4:
Program Managers Name Email and Telephone Number_4:
North American Industry Classification System NAICS Code_4:
CPARSPPIRS Completed_4:
Description of the Requirement Provide a concise explanation of the work performed specifically related to how it is relevant to this solicitations requirements_4:
Performance Explain any performance issues or problems that occurred corrective actions taken and any expected or realized results based on those corrective actions Any issues discussed in a CPARSPPIRS report for this reference are to be addressed_4:
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