ATTACHMENT G - PAST PERFORMANCE REFERENCE_NX EQ Image-Guided Surgical Navigation System.docx
DOCX document 25 KB Posted
- Solicitation number
- 36C10G26R0009
About this file
This is a past performance reference template for the NX EQ Image-Guided Surgical Navigation System solicitation (36C10G26R0009) issued by the Department of Veterans Affairs. The document serves as an appendix template for offerors to submit relevant past performance information demonstrating their experience delivering comparable products and services.
The template provides three structured sections for past performance references, with each section requiring offerors to identify the company that performed the work, their relationship to the offeror (prime or subcontractor), the contracting organization, contract or task order number, contract type, awarded and final prices, delivery dates and periods of performance, contracting officer and program manager contact information, and applicable NAICS codes. For each reference, offerors must provide a concise description of the work performed and its relevance to the solicitation requirements, along with an explanation of any performance issues encountered, corrective actions implemented, and results achieved. The template explicitly notes that any issues documented in CPARS/PPIRS reports must be addressed in the response. This attachment is a completion template rather than substantive guidance, designed to ensure offerors provide standardized, comparable past performance data for the VA's evaluation of their qualifications to supply the NX EQ Image-Guided Surgical Navigation Systems under this commercial items procurement.
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ATTACHMENT G: PAST PERFORMANCE REFERENCE
NX EQ Image-Guided Surgical Navigation System
SOLICITATION: 36C10G26R0009
☐ 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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