ATTACHMENT E_Past Performance References_36C10X26Q0110.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C10X26Q0110
About this file
This is a Past Performance References template for solicitation 36C10X26Q0110, a Request for Quotes (RFQ) issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick for Non-Powered Patient Transfer Standing Aids. The document is a blank form designed for offerors to submit relevant past performance references demonstrating their experience delivering similar products or services. The template accommodates up to three past performance references, each requiring offerors to identify whether they performed the work as a prime contractor or subcontractor, provide the contracting organization name, contract/task order number, contract type, awarded and final prices, delivery dates and performance periods, and contracting officer and program manager contact information. Additionally, offerors must document the NAICS code, indicate CPARS completion status, and provide detailed descriptions of work performed that directly relate to the solicitation requirements.
For each reference, offerors must explain the requirement with specific relevance to the current solicitation and address any performance issues, corrective actions taken, and results achieved. The document notes that there is "no record of relevant or recent past performance" available, indicating this is a template for new offerors or those without established performance history. Only new original equipment manufacturer (OEM) products are acceptable under this solicitation; refurbished, remanufactured, or gray market items are not permitted. Delivery will be FOB Destination to locations and dates specified in individual orders issued under the contract.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT G_Template for Industry Questions A0001.xlsx | XLSX spreadsheet | |
| ATTACHMENT F_Past Performance Questionnaire_36C10X26Q0110 A0001.docx | DOCX document | |
| ATTACHMENT D_Price Cost Schedule_36C10X26Q0110 A0001.xlsx | XLSX spreadsheet | |
| 36C10X26Q0110_2.docx | DOCX document | |
| ATTACHMENT G_Template for Industry Questions.xlsx | XLSX spreadsheet | |
| ATTACHMENT C_Sales Reporting Tool_36C10X26Q0110.xlsx | XLSX spreadsheet | |
| ATTACHMENT D_Price Cost Schedule_36C10X26Q0110.xlsx | XLSX spreadsheet | |
| ATTACHMENT F_Past Performance Questionnaire_36C10X26Q0110.docx | DOCX document | |
| ATTACHMENT B_Product Description_36C10X26Q0110.docx | DOCX document | |
| ATTACHMENT A_RFQ 36C10X26Q0110.pdf | ||
| 36C10X26Q0110.docx | DOCX document |
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Text version
ATTACHMENT E: PAST PERFORMANCE REFERENCES
Non-Powered Patient Transfer Standing Aid
SOLICITATION: 36C10X26Q0110
☐ No record of relevant or recent past performance.
Past Performance Reference # 1
OFFEROR NAME:
COMPANY who performed this work:
| Relationship to offeror: |
| ☐ OFFEROR ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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 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.]
[Description of Requirement Continued]
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 report for this reference are to be addressed.]
Past Performance Reference # 2
OFFEROR NAME:
COMPANY who performed this work:
| Relationship to offeror: |
| ☐ OFFEROR ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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 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.]
[Description of Requirement Continued]
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 report for this reference are to be addressed.]
Past Performance Reference # 3
OFFEROR NAME:
COMPANY who performed this work:
| Relationship to offeror: |
| ☐ OFFEROR ☐ SUBCONTRACTOR |
| Role on the Contract: |
| ☐ 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 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.]
[Description of Requirement Continued]
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 report for this reference are to be addressed.]
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