ATTACHMENT G_PAST PERFORMANCE REFERENCE - NX EQ CRYOTHERAPY SYSTEMS.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C10G25Q0093
About this file
This document is an Attachment G Past Performance Reference form for Solicitation 36C10G25Q0093, issued by the Veterans Health Administration (VHA) for a national single Requirements contract for Cryotherapy Systems: Tissue Ablation - Endoscopic. The form provides a template for offerors to document three past performance references, with sections for contract details, performance descriptions, and potential performance issues. However, the current document contains no actual completed references, with each section left blank.
The related federal contract opportunity seeks a VA-wide contract for cryotherapy systems, requiring offerors to provide detailed product information including brand names, make/model numbers, and descriptive literature that demonstrates how their products meet the solicitation's salient characteristics and quality requirements. The solicitation is being issued as a Request for Quote (RFQ) using streamlined procedures for commercial items, with the goal of establishing a Requirements contract for tissue ablation endoscopic cryotherapy systems across the Veterans Health Administration.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10G25Q0093 Vendor Questions.docx | DOCX document | |
| 36C10G25Q0093 0001 SF30.docx | DOCX document | |
| 36C10G25Q0093_1.docx | DOCX document | |
| ATTACHMENT F_PAST PERFORMANCE QUESTIONNAIRE - NX EQ CRYOTHERAPY SYSTEMS.docx | DOCX document | |
| ATTACHMENT A - PRICE COST SCHEDULE - NX EQ CRYOTHERAPY SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT C_CONTRACT CLAUSES - NX EQ CRYOTHERAPY SYSTEMS.docx | DOCX document | |
| 36C10G25Q0093.docx | DOCX document | |
| ATTACHMENT E_REPORTING TOOL - NX EQ CRYOTHERAPY SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT H_RFQ QUESTIONS - NX EQ CRYOTHERAPY SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT D_SOLICITATION PROVISIONS - NX EQ CRYOTHERAPY SYSTEMS.docx | DOCX document | |
| ATTACHMENT B _CONTRACT ADMINISTRATION - NX EQ CRYOTHERAPY SYSTEMS.docx | DOCX document |
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ATTACHMENT G: PAST PERFROMANCE REFERENCE
NX EQ Cryotherapy Systems
SOLICITATION: 36C10G25Q0093
☐ 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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