D.1 Atch Ref Contract Wrksht 36C26226Q0144 IONM.pdf
PDF 324 KB Posted
- Attached to
- Q510--Intraoperative Neuromonitoring (IONM) Services VA San Diego Healthcare System (VASDHS)
- Solicitation number
- 36C26226Q0144
About this file
This is a Reference Contract Worksheet template (Form D.1) for solicitation 36C26226Q0144 designed to collect offeror experience information for evaluation purposes.
The worksheet requires offerors to document relevant contract experience by providing: the legal name of the contracting entity (with example: Veterans Affairs, VISN 22); the contract number; confirmation of whether the contract involved Intraoperative Neuromonitoring Services; detailed descriptions of specific tasks performed; geographic location of service delivery (with example: Los Angeles, CA); contract performance dates; the total number of Intraoperative Neuromonitoring cases performed; and contact information (name, phone, email) of a verifiable reference at the contracting entity. Offerors must also describe any other relevant information about their experience and how it relates to the Intraoperative Neuromonitoring services requested in the Statement of Work.
The government emphasizes that general experience claims without the required supporting information are unacceptable. The note warns that failure to submit complete information using this worksheet may be viewed as evidence that the offeror lacks experience providing the required services when evaluating proposals for the Experience evaluation factor. This template serves as a critical documentation tool for substantiating offeror qualifications in the competitive evaluation process.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ 36C26226Q0144 0001 IONM Services VASDHS.pdf | ||
| 36C26226Q0144 SOW update.pdf | ||
| RFQ 36C26226Q0144 IONM Services VASDHS.pdf | ||
| D.2 Atch Imig Natn Act1952 Amded 36C26226Q0144 IONM.pdf | ||
| 36C26226Q0144_1.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
36C26226Q0144
D.1 Reference Contract Worksheet
Reference Contract
The legal name of entity with whom the Offeror (or Offeror’s proposed subcontractor) held the contract.
(example: Veterans Affairs, VISN 22)
Contract Number
Whether the contract was for Intraoperative Neuromonitoring Services.
A description providing details of the specific tasks the Offeror (or Offeror’s proposed subcontractor) performed under that contract.
In what geographic location the Offeror (or Offeror’s proposed subcontractor) performed these services.
(example: Los Angeles, CA)
The dates during which the Offeror (or Offeror’s proposed subcontractor) performed the contract.
36C26226Q0144
The number of Intraoperative Neuromonitoring cases that were performed under that contract.
The name, phone number, and email address of a person at the entity with whom the Offeror (or Offeror’s proposed subcontractor) held the contract who can verify the information the Offeror provides in the narrative description for this factor.
NOTE: The information requested above is required for the Government to evaluate proposals for the Experience evaluation factor. General statements claiming experience providing Chiller Preventative Maintenance Services that do not include the information required above, are not acceptable. FAILURE TO SUBMIT THE INFORMATION REQUIRED ABOVE, USING SECTION D.1
REFERENCE CONTRACT WORKSHEET, TO SUPPORT THE OFFEROR’S CLAIMED
EXPERIENCE MAY BE VIEWED BY THE GOVERNMENT AS EVIDENCE THAT THE OFFEROR
LACKS EXPERIENCE PROVIDING CHILLER PREVENTATIVE MAINTENANCE SERVICES WHEN
EVALUATING QUOTES FOR THE EXPERIENCE EVALUATION FACTOR.
Any other relevant information about this experience or how it relates to the Intraoperative Neuromonitoring services requested by the SOW.
| D.1 ATTACHMENT 1 – Reference Contract Worksheet for Offeror’s Response to |
| Factor 1 – Experience |
| Reference ContractRow1: |
| subcontractor held the contract: |
| Contract Number: |
| Contract NumberRow1: |
| Whether the contract was for Board CertifiedBoardEligible Psychiatrist Physician Services in a healthcare setting Yes No: |
| A description providing details of the specific tasks the Offeror or Offerors proposed subcontractor performed under that contractRow1: |
| A description providing details of the specific tasks the Offeror or Offerors proposed subcontractor performed under that contractRow2: |
| performed these services: |
| The dates during which the Offeror or Offerors proposed subcontractor performed the contract: |
| performed the contract: |
| The number of patients to whom the Offeror or Offerors proposed subcontractor provided Board CertifiedBoardEligible Psychiatrist Physician Services in a healthcare setting under that contract: |
| Whether the Offeror or its proposed subcontractor was the prime contractor or a subcontractor for that provided reference contract: |
| The name phone number and email: |
| The name phone number and email address of a person at the entity with whom the Offeror or Offerors proposed subcontractor held the contract who can verify the information the Offeror provides in the narrative description for this factor: |
| undefined: |
| Text1: |
| Text2: |
File details come from the government source that posted it. Updated .