Attachment C - Past Performance References.pdf

PDF 155 KB Posted

Attached to
R425 National VHA Biomedical Engineering Technical Professional Support Services (BETPSS) IDIQ
Solicitation number
36C10X26R0010
Issued by

About this file

This is a Past Performance References template used for federal contract proposals. The document provides a standardized form for offerors to submit information about up to three relevant past performance references, which are evaluated as part of the competitive proposal process.

The template requires offerors to complete detailed information for each reference, including: the name of the company that performed the work and its relationship to the offeror (whether the offeror performed as prime contractor or the company was a proposed subcontractor); the contracting organization name; contract or task order number; contract type; total awarded price and final/projected final price; delivery date and period of performance; contracting officer and program manager contact information; and the applicable NAICS code. For each reference, offerors must provide a concise description of the work performed and explain its relevance to the current solicitation's requirements. Additionally, offerors must address any performance issues or problems that occurred during execution, detail corrective actions taken, and describe expected or realized results from those corrective actions. The template explicitly requires that any issues documented in CPARS/PPIRS (Contractor Performance Assessment Reporting System/Past Performance Information Retrieval System) reports be addressed. The document includes space for three separate past performance references and also provides a checkbox option to indicate "No record of relevant or recent past performance" if applicable.

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D.1 ATTACHMENT C: 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.

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

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

Past Performance Reference # 3

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

Program Manager's Name, Email, and

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

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:
undefined:
NO:
Description of the Requirement Provide a concise explanation of the work performed specifically related:
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:
OFFEROR_2:
PROPOSED SUBCONTRACTOR_2:
undefined_2:
PRIME_2:
SUBCONTRACTOR_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:
YES:
NO_2:
Description of the Requirement Provide a concise explanation of the work performed specifically related_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:
OFFEROR_3:
PROPOSED SUBCONTRACTOR_3:
undefined_3:
PRIME_3:
SUBCONTRACTOR_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:
YES_2:
NO_3:
Description of the Requirement Provide a concise explanation of the work performed specifically related_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:

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