Attachment E Past Performance Reference Form.docx
DOCX document 41 KB Posted
- Attached to
- 8940--SPV-6 Federal contract opportunity
- Solicitation number
- 36W79723R0001
- Issued by
- Department of Veterans Affairs
About this file
This document contains an attachment for a past performance reference form and details of a related federal contract opportunity for a Subsistence Prime Vendor program. The past performance reference form seeks references from at least five of the offeror's most recent healthcare prime vendor or program accounts. It requests contact information for the reference and details about the account, including whether it was a prime vendor account, annual purchases, facility size and type, foodservice details, and whether customer satisfaction surveys were conducted.
The related federal contract opportunity is solicitation number 36W79723R0001 for the Subsistence Prime Vendor program SPV-6 effective November 1, 2023. The opportunity is with the Department of Veterans Affairs to establish prime vendor contracts for the distribution of food and non-food items to various Department of Veterans Affairs Medical Centers and other authorized customers. It provides details on the products and services required to support this prime vendor program.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36W79723R0001 0003.docx | DOCX document | |
| 36W79723R0001 0002.docx | DOCX document | |
| 36W79723R0001 0001 - Extend Response Due Date - FINAL.pdf | ||
| 36W79723R0001 0001.docx | DOCX document | |
| Attachment I Mandatory Listing of Supplies.pdf | ||
| Attachment H Market Basket.xlsx | XLSX spreadsheet | |
| Attachment F Past Performance Questions.docx | DOCX document | |
| Attachment D Customer Delivery Information.xlsx | XLSX spreadsheet | |
| Attachment A Customer Data.xlsx | XLSX spreadsheet | |
| 36W79723R0001.docx | DOCX document | |
| Attachment G SubK Plan Template.docx | DOCX document | |
| Attachment C Price Schedule.xls | XLS spreadsheet | |
| Attachment B Product Categories.pdf |
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Text version
SPV-6 Attachment E
Past Performance Information
Past performance is an evaluation Sub-factor for this contract. Offeror shall provide data that represents the past performance capabilities of their organization. This information must be provided on Attachments E and F. Data represents how Contractor may be utilized in determining whether the work performed for these references is relevant to the work performed under the VA SPV contract. Offeror will be required to submit contact information on current customers for interviews by the Government. Other data that must be provided if available to evaluate past performance is:
a) Warehouse external sanitation reports and scores.
b) Metrics used by contractor to monitor customer satisfaction with service.
Make additional copies of Attachment E as needed.
Use additional paper as needed to complete Attachment F.
Attachment E: Past Performance Reference Form
OFFEROR’S Name:
Please fill out one form for each of your five (three for each Contractor member of a teamed effort) most recent healthcare prime vendor or program accounts. This form may be duplicated. The Government intends to contact these references, verify data, and/or request additional information on Offeror’s performance.
1. Customer Name:
Address:
2. Point of Contact Name:
Job Title:
Telephone Number:
Email Address:
3. Contact Information:
a. Is this a Prime Vendor Account?
b. Is this Account affiliated with a Group Buying/Purchasing Organization?
If yes, specify organization:
c. How long has this account been a customer of Offeror?
d. Number of Deliveries per Week:
e. Estimated Annual Purchases:
4. Size and Type of Facility: Check all applicable
a. Type of Facility.
Private |_| Public |_| Acute Care Hospital |_| Long Term Care Facility |_| Nursing Home |_| Retirement/Assisted Living |_|
b. Size of Facility:
Daily Census:
Average Daily Meals Served:
c. Type of Foodservice: Check all applicable Tray Service Cook Serve: |_| or Tray Service Cold Plate/Retherm |_| Room Service: |_|
| Dining Room-Tray Service: |_| or Dining Room-Self Serve: |_| |
| Retail Cafeteria: |_| |
5. Has this customer been surveyed by Offeror for satisfaction with Offeror’s performance?
Attachment E - Past Performance Page 2 of 2
File details come from the government source that posted it. Updated .