D.1 Reference Contract Worksheet Nurse Staffing Services.docx

Attachment D.1 – Reference Contract Worksheet for Offeror’s Response to STEP 2, Factor 1 – Experience Reference Contract Worksheet # ______

Contract Number

The dates during which the Offeror (or Offeror’s proposed subcontractor) performed the contract

LVN ________ Specialty RN __________

NP _________

Whether the provided reference contract is for services provided by the Offeror or provided by a proposed subcontractor of the Offeror’s

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 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 that is requested above is required for the Government to evaluate proposals for the Experience evaluation factor. General statements claiming experience providing contracted nurse staffing services that do not include specific references to prior contract work, or that do not include the information required above, are not acceptable. FAILURE TO SUBMIT THE INFORMATION REQUIRED ABOVE TO SUPPORT THE OFFEROR’S CLAIMED EXPERIENCE MAY BE VIEWED BY THE GOVERNEMNT AS EVIDENCE THAT THE OFFEROR (OR OFFEROR’S PROPOSED SUBCONTRACTOR) LACKS EXPERIENCE PROVIDING NURSE STAFFING SERVICES WHEN EVALUATING PROPOSALS FOR THE EXPERIENCE EVALUATION FACTOR IN STEP 2 OF PROPOSAL EVALUATIONS.