ATTACHMENT F - PAST PERFORMANCE REFERENCE - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.docx
DOCX document 18 KB Posted
- Solicitation number
- 36C10X26Q0168
About this file
This is a Past Performance Reference template for vendors responding to a solicitation for NX EQ Dental Radiographic Units (Intraoral X-Ray systems). The template is designed to collect information from offerors regarding their relevant experience delivering similar dental radiographic equipment to government or commercial customers. It functions as an appendix to the broader solicitation and does not specify required products, services, pricing terms, or award dates. Rather, it provides a standardized format for vendors to document their qualifications and track record with comparable dental imaging equipment, allowing the Department of Veterans Affairs Strategic Acquisition Center Frederick to evaluate contractor capability and reliability based on past performance metrics. This reference form is part of the evaluation criteria for the combined synopsis/solicitation (36C10X26Q0168) issued as a Request for Quote under streamlined commercial item procedures.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10X26Q0168 0001.docx | DOCX document | |
| ATTACHMENT G - PAST PERFORMANCE QUESTIONNAIRE - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.docx | DOCX document | |
| ATTACHMENT C - CONTRACT CLAUSES - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL -.docx | DOCX document | |
| ATTACHMENT B - CONTRACT ADMINISTRATION - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.docx | DOCX document | |
| ATTACHMENT A - PRICE COST SCHEDULE - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.xlsx | XLSX spreadsheet | |
| ATTACHMENT E - REPORTING TOOL - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.xlsx | XLSX spreadsheet | |
| ATTACHMENT D - SOLICITATION PROVISIONS - NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL.docx | DOCX document | |
| 36C10X26Q0168.docx | DOCX document |
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ATTACHMENT F: PAST PERFORMANCE REFERENCE
NX EQ DENTAL RADIOGRAPHIC UNITS INTRAORAL
SOLICITATION: 36C10X26Q0168
☐ 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/PPIRS Completed:
Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.
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/PPIRS 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/PPIRS Completed:
Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.
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/PPIRS 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/PPIRS Completed:
Description of the Requirement: Provide a concise explanation of the work performed, specifically related to how it is relevant to this solicitation’s requirements.
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/PPIRS report for this reference are to be addressed.
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