ATTACHMENT F - PAST PERFORMANCE REFERENCE - NX EQ Endoscope Cabinets-Vertical .docx

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6515--NX EQ Endoscope Drying and Storage Cabinets - Vertical
Solicitation number
36C10G25R0044
Issued by

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This document is an Attachment F Past Performance Reference form for Solicitation 36C10G25R0044, relating to NX EQ Endoscope Drying and Storage Cabinets - Vertical for the Department of Veterans Affairs. The form is designed to capture past performance information from potential contractors, but in this instance, all three reference sections are marked with "No record of relevant or recent past performance," indicating the offeror has not provided any specific contract history for this procurement. The solicitation seeks vertical endoscope drying and storage cabinets designed to reduce infection risks by removing moisture from endoscopes and providing a controlled storage environment with HEPA and activated carbon filtration, to be used across VA Medical Centers nationwide.

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36C10G25R0044

ATTACHMENT F: PAST PERFORMANCE REFERENCE

NX EQ Endoscope Drying and Storage Cabinets - Vertical

SOLICITATION: 36C10G25R0044

☐ 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.

☐ No record of relevant or recent past performance.

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.

☐ No record of relevant or recent past performance.

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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