ATTACHMENT E_PAST PERFORMANCE REFERENCES_NX EQ AB Scan.docx
DOCX document 29 KB Posted
- Solicitation number
- 36C10X26R0055
About this file
This is a Past Performance References template for solicitation 36C10G26R0055, a Request for Proposal issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick for NX EQ Scanning Systems Ultrasonic Ophthalmic AB Scan equipment and related accessories. The template is designed for offerors to document three past performance references demonstrating relevant experience with similar medical equipment procurement or delivery.
The template requires offerors to provide detailed information for each reference, including the contracting organization, contract or task order number, contract type, total awarded and final costs, delivery periods, contracting officer and program manager contact information, and the applicable NAICS code. For each reference, offerors must describe the requirement and its relevance to the current solicitation, explain any performance issues encountered along with corrective actions taken, and document realized results. The document notes that "No record of relevant or recent past performance" exists at the time of issuance, indicating this is a new or newly advertised requirement. This acquisition is set-aside for Service-Disabled Veteran-Owned Small Business (SDVOSB) concerns, and only new OEM equipment is acceptable; refurbished, remanufactured, or gray market items are not permitted.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT D_Template for Industry Questions_NX EQ AB Scan.xlsx | XLSX spreadsheet | |
| ATTACHMENT A_PRICE COST SCHEDULE_NX EQ AB Scan.xlsx | XLSX spreadsheet | |
| 36C10X26R0055_1.docx | DOCX document | |
| ATTACHMENT F_PAST PERFORMANCE QUESTIONNAIRE_NX EQ AB Scan.docx | DOCX document | |
| 36C10X26R0055 - RFP.docx | DOCX document | |
| ATTACHMENT C_SALES REPORTING TOOL_NX EQ AB Scan.xlsx | XLSX spreadsheet | |
| ATTACHMENT B_Product Description NX EQ AB Scan.docx | DOCX document |
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ATTACHMENT E: PAST PERFORMANCE REFERENCES
NX EQ Scanning Systems Ultrasonic Ophthalmic AB Scan
SOLICITATION: 36C10G26R0055
☐ 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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