D.2 PAST PERFORMANCE REFERENCES.rtf

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Attached to
N063--Physical Access Control System (PACS) 671-23-1-5554-0012 (VA-23-00037147)
Solicitation number
36C25723Q0317
Issued by

About this file

This document contains a past performance reference template for a federal solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17. The solicitation seeks a contractor to provide a Physical Access Control System in accordance with the statement of work. The template includes fields for contractors to provide three references, including the name, address, contract number and value, dates of performance, and point of contact information for previous government or commercial contracts. Contractors must also disclose whether any contracts were terminated for cause or default, and if any contract discrepancy reports were filed.

Text of this file

D.2 ATTACHMENT 36C25623Q0317 – PAST PERFORMANCE REFERENCES

REFERENCE 1:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as:Prime ContractorSub-Contractor
Dates of Performance (if current include expiration):Total Value of Contract:

Any terminations for cause or default? Circle YES or NO

If yes, brief explanation:Any contract discrepancy reports filed? Circle YES or NO
If yes, brief explanation:Point Of Contact/COR:
Title:Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 2:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as:Prime ContractorSub-Contractor
Dates of Performance (if current include expiration):Total Value of Contract:

Any terminations for cause or default? Circle YES or NO

If yes, brief explanation:Any contract discrepancy reports filed? Circle YES or NO
If yes, brief explanation:Point Of Contact/COR:
Title:Telephone Number:

Point of Contact’s email address:

Comments:

file_0.wmf

REFERENCE 3:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as:Prime ContractorSub-Contractor
Dates of Performance (if current include expiration):Total Value of Contract:

Any terminations for cause or default? Circle YES or NO

If yes, brief explanation:Any contract discrepancy reports filed? Circle YES or NO
If yes, brief explanation:Point Of Contact/COR:
Title:Telephone Number:

Point of Contact’s email address:

Comments:

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