Attachment L - Clinical Pathology Staffing Worksheet.docx
DOCX document 15 KB Posted
- Attached to
- Q515--Pathology and Laboratory Staffing Services
- Solicitation number
- 36C26223R0009
About this file
This document contains a staffing worksheet template for evaluating proposals to provide clinical pathology staffing services to the Department of Veterans Affairs. The worksheet requires offerors to provide details of the most recent reference contract for each subspecialty of medical laboratory technician, medical technologist, and phlebotomist. Required details include the contract and facility names, dates of service, contact information for a reference at the facility, and the name of the staffing company that provided the services. The related federal contract opportunity is solicitation number 36C26223R0009 from the VA for pathology and laboratory staffing services across VISN 22. Offerors must complete this worksheet for proposal evaluations under Step 1 for each subspecialty being proposed.
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ATTACHMENT L - Clinical Pathology Staffing Worksheet
The information collected by this Worksheet will be used to evaluate proposals for STEP 1 of proposal evaluations. Offerors submitting proposals to provide clinical pathology staffing services must complete each Table shown below for the most recent reference contract only for each subspecialty and submit the completed Worksheet with their proposal. Each subspecialty Table may reference a different contract, but each Table must contain the information pertaining to only one contract, namely, the most recent reference contract the Offeror wishes to submit for evaluation for that subspecialty under STEP 1 of proposal evaluations. Offerors must complete each Table entry unless the Table entry is marked as “Optional.”
| Clinical Pathology Staff Subspecialty: |
| Medical Laboratory Technician |
Contract Number/ID (Optional):
Name of Healthcare Facility Receiving These Staffing Services:
Dates These Staffing Services Were Provided:
Name of Healthcare Facility Point of Contact Who Can Verify Services Provided:
Contact Information for Healthcare Facility Point of Contact (Email or Phone Number):
Name of Staffing Company Who Provided These Services:
| Clinical Pathology Staff Subspecialty: |
| Medical Technologist |
Contract Number/ID (Optional):
Name of Healthcare Facility Receiving These Staffing Services:
Dates These Staffing Services Were Provided:
Name of Healthcare Facility Point of Contact Who Can Verify Services Provided:
Contact Information for Healthcare Facility Point of Contact (Email or Phone Number):
Name of Staffing Company Who Provided These Services:
| Clinical Pathology Staff Subspecialty: |
| Phlebotomist |
Contract Number/ID (Optional):
Name of Healthcare Facility Receiving These Staffing Services:
Dates These Staffing Services Were Provided:
Name of Healthcare Facility Point of Contact Who Can Verify Services Provided:
Contact Information for Healthcare Facility Point of Contact (Email or Phone Number):
Name of Staffing Company Who Provided These Services:
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