Attachment II - Past Performance Questionnaire.docx

DOCX document 16 KB Posted

Attached to
Medical Doctor SME Federal contract opportunity
Solicitation number
70RDAD20R00000018
Issued by
Department of Homeland Security Office of Procurement Operations

About this file

This document contains an attachment for past performance references and a solicitation notice for a medical doctor subject matter expert opportunity. The attachment requests information on up to three relevant past contracts, including customer and reference contact details, contract numbers, types and values, dates, descriptions of work performed, and problems encountered. The solicitation is a request for proposal from the Department of Homeland Security's Office for Procurement Operations to provide medical doctor subject matter expert support to the Office for Civil Rights and Civil Liberties. The opportunity is a fixed price contract for advisory and consulting services on medical and health-related matters. Responses are due by the date listed on the federal business opportunities website.

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Text version

Attachment II - Past Performance Information Form

(Offerors are required to complete this form for no more than three (3) separate relevant contracts/projects)

Offeror:

Company Group / Division:

Program, Project, Or Task Title:

REFERENCE INFORMATION

1
Customer Name:
2
Address:
Customer Info:
Contracting Contact
Program / Project Manager or COR
3
Name & Title:
4
Organization:
5
Address:
5
Phone No.:
6
Fax No.:
7
E-mail:
8
Contract Number:
9
Contract Type (e.g. contract, BPA, task order) and pricing type (e.g. fixed price, cost reimbursement):
10
Dollar Value (Not-to Exceed):

Cumulative funded amount:

11
Project Start Date

Estimated/Actual Completion Date:

12
Current status, e.g. completed and/or in progress

Description of Work Performed and Relevance to Requirements in this RFP

Problems Encountered and Resolutions

File details come from the government source that posted it. Updated .