ATTACHMENT G - PAST PERFORMANCE REFERENCE_NX EQ Image-Guided Surgical Navigation System.docx
DOCX document 25 KB Posted
- Solicitation number
- 36C10X27R0004
About this file
This is a Past Performance Reference template document for the NX EQ Image-Guided Surgical Navigation System solicitation 36C10X27R0004. The template is designed for offerors to provide three past performance references demonstrating relevant experience delivering similar systems or related products and services to the federal government or commercial entities.
The template requires offerors to complete detailed information for each reference, including the performing company name, whether the offeror served as prime or subcontractor, the contracting organization, contract or task order number, contract type, awarded and final costs, period of performance, contracting officer and program manager contact information, and NAICS code. For each reference, offerors must provide a concise description of work performed and its relevance to this solicitation's requirements, along with an explanation of any performance issues encountered, corrective actions taken, and results achieved. The document specifically notes that any performance issues documented in CPARS/PPIRS reports must be addressed in the response. The template indicates that as of the document creation, there was no record of relevant or recent past performance on file. Offerors responding to this VA solicitation for Service-Disabled Veteran-Owned Small Businesses must complete this attachment to demonstrate their capability to deliver new OEM NX EQ Image-Guided Surgical Navigation Systems equipment on an FOB Destination basis.
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ATTACHMENT G: PAST PERFORMANCE REFERENCE
NX EQ Image-Guided Surgical Navigation System
SOLICITATION: 36C10X27R0004
☐ 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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