ATTACHMENT D.4 - PAST PERFORMANCE REFERENCES.pdf
PDF 345 KB Posted
- Attached to
- Q519-- Psychiatrist Services Federal contract opportunity
- Solicitation number
- 5802032180010
About this file
This document includes an attachment requesting past performance references and details of a federal contract opportunity for psychiatrist physician services.
The Department of Veterans Affairs Network Contracting Office 16 in Houston, Texas is seeking quotes for onsite psychiatrist services at the Michael E. DeBakey VA Medical Center in Houston and its nine community-based outpatient clinics. Services will be provided under solicitation number 5802032180010. This is a set-aside for service-disabled veteran-owned small businesses registered in the System for Award Management and Vendor Information Pages. Quotes are due by the response date listed in the solicitation and will only be accepted electronically. The opportunity is valued at an estimated $30 million annually under NAICS code 561320 for temporary help services. The contract will provide psychiatrist evaluation, medication management, and mental health treatment to eligible VA beneficiaries.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25620Q0622 0002.docx | DOCX document | |
| 36C25620Q0622 0001.docx | DOCX document | |
| ATTACHMENT D.1 -QASP.pdf | ||
| RFQ - 36C25620Q0622- PSYCHIATRIST SERVICES HOUSTON_TX.pdf | ||
| ATTACHMENT D.2 - CONFLICT OF INTEREST.pdf | ||
| ATTACHMENT D.5 - PAST PERFORMANCE QUESTIONNAIRE.pdf | ||
| ATTACHMENT D.3 - CONTRACTOR CERTIFICATION-IMMIGRATION CERTIFICATION.pdf |
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Text version
ATTACHMENT D.5 – 36C25620Q0622 – Psychiatrist Physician Services
PAST PERFORMANCE REFERENCES
REFERENCE 1:
Name of Government or Commercial Organization:______________________________
Address:_________________________________
Contract Number:______________________________
Brief Description:_________________________________________________________
Contractor Performed as: Prime Contractor Sub-Contractor
Dates of Performance (if current include expiration):____________________
Total Cost of Contract:__________________Award/Incentive/Deduction_____________
Any terminations for cause or default? Circle YES or NO
If yes, brief explanation:___________________________
Point Of Contact/COR:____________________________
Title:___________________________________
Telephone Number:____________________________
Point of Contact’s email address:______________________
Comments:______________________________________________________________
REFERENCE 2:
Name of Government or Commercial Organization:______________________________
Address:_________________________________
Contract Number:______________________________
Brief Description:_________________________________________________________
Contractor Performed as: Prime Contractor Sub-Contractor
Dates of Performance (if current include expiration):____________________
Total Cost of Contract:__________________Award/Incentive/Deduction_____________
Any terminations for cause or default? Circle YES or NO
If yes, brief explanation:___________________________
Point Of Contact/COR:____________________________
Title:___________________________________
Telephone Number:____________________________
Point of Contact’s email address:______________________
Comments:______________________________________________________________
ATTACHMENT D.5 – 36C25620Q0622 – Psychiatrist Physician Services
REFERENCE 3:
Name of Government or Commercial Organization:______________________________
Address:_________________________________
Contract Number:______________________________
Brief Description:_________________________________________________________
Contractor Performed as: Prime Contractor Sub-Contractor
Dates of Performance (if current include expiration):____________________
Total Cost of Contract:__________________Award/Incentive/Deduction_____________
Any terminations for cause or default? Circle YES or NO
If yes, brief explanation:___________________________
Point Of Contact/COR:____________________________
Title:___________________________________
Telephone Number:____________________________
Point of Contact’s email address:______________________
Comments:______________________________________________________________
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