D.2 PAST PERFORMANCE REFERENCES.rtf

RTF text file 227 KB Posted

Attached to
Water Reverse Osmosis
Solicitation number
36C25726Q0785
Issued by

About this file

This is a Past Performance References template form required for submission in response to solicitation 36C25726Q0785 for Water Reverse Osmosis services. The form is designed to collect three separate past performance references from offerors, with each reference requiring detailed information about the contractor's experience with government or commercial organizations.

For each reference, the template requires offerors to provide the organization name and address, contract number, a brief description of work performed, and whether the contractor served as prime or subcontractor. Additional required information includes performance dates, total contract value, disclosure of any terminations for cause or default with explanations if applicable, and notification of any contract discrepancy reports filed with explanations. The form also requires point of contact information for contract administration, including the Contracting Officer's Representative (COR) or point of contact name, title, telephone number, and email address, along with a comments section for each reference. This template serves as an evaluation tool for the Department of Veterans Affairs Veterans Health Administration to assess contractor capability and performance history in delivering reverse osmosis water system services.

Text of this file

D.2 ATTACHMENT 36C25726Q0785 – PAST PERFORMANCE REFERENCES

REFERENCE 1:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as (check one): 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 (check one): 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 (check one): 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:

Other files

File Type Posted
D.1 Wage Determination 2015-5253 Rev. 29.pdf PDF
36C25726Q0785 0003_.pdf PDF
36C25726Q0785 0002.pdf PDF
36C25726Q0785 0001.pdf PDF
D.3 ATTACHMENT.docx DOCX document
D.1 Wage Determination 2015 5253 Rev 12 3 2025.pdf PDF
S02 36C25726Q0785_.pdf PDF

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