ATTACHMENT G - PAST PERFORMANCE REFERENCE_NX EQ Monitor Video Medical.docx
DOCX document 25 KB Posted
- Solicitation number
- 36C10X26R0018
About this file
This is a Past Performance Reference form template for solicitation 36C10X26R0018, issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick for NX EQ Monitor: Video: Medical products. The document serves as a blank template requiring offerors to document three past performance references demonstrating relevant experience delivering similar products or services.
The form requests detailed information for each reference, including the company name, relationship to the offeror (prime or subcontractor role), contracting organization, contract/task order numbers, contract type, total awarded and final prices, delivery periods and performance dates, contracting officer and program manager contact information, and NAICS codes. For each reference, offerors must provide a concise description of work performed and its relevance to the current solicitation requirements, along with an explanation of any performance issues that occurred, corrective actions taken, and results achieved. The template notes that any performance issues documented in CPARS/PPIRS reports must be addressed in the submission. The form indicates that no record of relevant or recent past performance has been identified for this particular requirement, emphasizing the importance of offerors providing comprehensive and credible past performance documentation to support their proposal.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10X26R0018_5.docx | DOCX document | |
| 36C10X26R0018_4.docx | DOCX document | |
| Amd_3 ATTACHMENT A PRICE COST SCHEDULE - NX EQ Monitor Video Medical.xlsx | XLSX spreadsheet | |
| 36C10X26R0018_3.docx | DOCX document | |
| 36C10X26R0018_2.docx | DOCX document | |
| 36C10X26R0018_1.docx | DOCX document | |
| ATTACHMENT C - CONTRACT CLAUSES_NX EQ Monitor Video Medical.docx | DOCX document | |
| ATTACHMENT E -QUARTERLY SALES REPORTING TOOL_NX EQ NX EQ Monitor Video Medical.xlsx | XLSX spreadsheet | |
| RFP 36C10G26R0018 - NX EQ Monitor Video Medical - Final.docx | DOCX document | |
| ATTACHMENT F - PAST PERFORMANCE QUESTIONNAIRE_NX EQ Monitor Video Medical.docx | DOCX document | |
| ATTACHMENT B - PRODUCT DESCRIPTION NX EQ Monitor Video Medical.docx | DOCX document | |
| ATTACHMENT H - CERTIFICATION OF RECALL OR SAFETY ISSUES_NX EQ Monitor Video Medical.docx | DOCX document | |
| ATTACHMENT D - SOLICITATION PROVISIONS_NX EQ Monitor.docx | DOCX document | |
| ATTACHMENT A PRICE COST SCHEDULE - NX EQ Monitor Video Medical.xlsx | XLSX spreadsheet |
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ATTACHMENT G: PAST PERFORMANCE REFERENCE
NX EQ NX EQ Monitors: Video: Medical
SOLICITATION: 36C10G26R0018
☐ 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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