ATTACHMENT E_PAST PERFORMANCE REFERENCES_NX EQ Cart Washer Disinfector Units.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C10X26R0015
About this file
This is a Past Performance References template for solicitation 36C10G26R0015 for cart and utensil washer disinfector units issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick. The document is an appendix designed for offerors to document their relevant past performance on three reference contracts. The template indicates that no record of relevant or recent past performance has been provided at this stage.
For each of the three past performance references, offerors must complete the following information: the company that performed the work and its relationship to the offeror (prime or subcontractor); the contracting organization; the contract or task order number; contract type; total awarded and final/projected final prices; delivery dates and period of performance; contracting officer and program manager contact information; NAICS code; and whether a CPARS report was completed. Additionally, offerors must provide a concise description of the work performed and its relevance to the solicitation requirements, as well as an explanation of any performance issues encountered, corrective actions taken, and results achieved. This template is blank and awaiting completion by offerors responding to the solicitation for new OEM cart and utensil washer disinfector units, which is set-aside for Service-Disabled Veteran-Owned Small Business (SDVOSB) concerns.
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ATTACHMENT E: PAST PERFORMANCE REFERENCES
Cart and Utensil Washer Disinfector Units
SOLICITATION: 36C10G26R0015
☐ 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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