D.2 Reference Contract Worksheet.pdf

Attachment D.2 – Reference Contract Worksheet HCHV Transitional Housing and Supportive Services for Offeror’s Response to Factor 1 – Experience

Reference Contract Worksheet # ______

The legal name of entity with whom the Offeror held the contract

(examples: Molina Healthcare, VA Long Beach Healthcare system, Dallas Memorial Hospital)

Contract Number

Whether the contract was for HCHV transitional housing and supportive services to Veterans in community-based facilities.

A description providing details of the specific tasks the Offeror performed under that contract.

In what geographic location the Offeror performed these services.

(example: Los Angeles, CA and Dallas, TX)

The dates during which the Offeror performed the contract.

The number of patients to whom the Offeror provided HCHV transitional housing and supportive services to Veterans in community-based facilities.

Whether the Offeror was the prime contractor or a subcontractor for that contract.

The name, phone number, and email address of a person at the entity with whom the Offeror 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 HCHV transitional housing and supportive services to Veterans in community-based facilities 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 GOVERNMENT AS

EVIDENCE THAT THE OFFEROR LACKS EXPERIENCE PROVIDING HCHV

TRANSITIONAL HOUSING AND SUPPORTIVE SERVICES TO VETERANS IN COMMUNITY-

BASED FACILITIES WHEN EVALUATING PROPOSALS FOR THE EXPERIENCE

EVALUATION FACTOR.