ATTACHMENT G_PAST PERFORMANCE REFERENCE NX EQ Ophthalmic Perimeters.pdf
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- Attached to
- NX EQ Ophthalmic Perimeters
- Solicitation number
- 36C10G25R0035
About this file
Attachment G is a Past Performance Reference form for the NX EQ Ophthalmic Perimeters solicitation (Solicitation Number: 36C10G25R0035) issued by the Department of Veterans Affairs. The document is a standardized template designed for offerors to provide detailed information about their previous contract performance, including sections for capturing the offeror's company details, contract specifics, and performance evaluation.
The form requires comprehensive documentation such as the company name, relationship to the offeror, contract type, total awarded price, period of performance, contracting officer and program manager contact information, and NAICS code. Two specific sections - "Description of the Requirement" and "Performance" - are included for offerors to explain the relevance of their past work to the current solicitation and to address any performance issues or corrective actions taken. This document is part of the Veterans Health Administration's procurement process for purchasing Ophthalmic Perimeters to support patient care at VA Medical Centers nationwide.
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ATTACHMENT G: PAST PERFORMANCE REFERENCE
NX EQ Ophthalmic Perimeters
SOLICITATION: 36C10G25R0035
☐ 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.
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