D.2 Reference Contract Worksheet.pdf
PDF 141 KB Posted
- Attached to
- Q999--VA Loma Linda Healthcare System 15-Bed Sober Living Transitional Housing Services - Amendment One (1)
- Solicitation number
- 36C26226R0117
About this file
This is a Reference Contract Worksheet template for offerors responding to a federal solicitation for Sober Living Transitional Housing Services to Veterans in community-based facilities.
The worksheet requires offerors to document their prior contract experience to support evaluation under Factor 1 – Experience. Offerors must complete the template for each relevant reference contract, providing: the legal name of the contracting entity, contract number, confirmation that the contract involved sober living transitional housing services to veterans in community-based facilities, detailed description of specific tasks performed, geographic locations where services were provided, contract performance dates, number of veterans served, prime or subcontractor status, and contact information for a reference person who can verify the submitted information. The document emphasizes that general experience statements without specific reference contract details and required supporting information are not acceptable and may result in the government viewing the offeror as lacking necessary experience. Failure to submit complete information for all required fields may negatively impact proposal evaluation.
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Other files
| File | Type | Posted |
|---|---|---|
| Questions and Answers Solicitation 36C26226R0117.pdf | ||
| 36C26226R0117 0001_2.docx | DOCX document | |
| RFP - 36C26226R0117 - VALLHS Sober Living Transitional Housing.pdf | ||
| 36C26226R0117_1.docx | DOCX document | |
| D.3 Wage Determination WD 2015-5629 Rev. 31.pdf | ||
| D.5 Catchment Map.pdf | ||
| D.4 Contractor Certification - Immigration and Nationality Act Of 1952.pdf | ||
| D.1 Price Worksheet.xlsx | XLSX spreadsheet |
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Text version
Attachment D.2 – Reference Contract Worksheet Sober Living Transitional Housing Services to
Veterans in Community-based Facilities 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 Sober Living
Transitional Housing 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 Sober Living Transitional Housing 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.
| Reference Contract Worksheet Row1: |
| examples Molina Healthcare VA Long Beach Healthcare system Dallas Memorial Hospital: |
| held the contract: |
| Contract Number: |
| Contract Number_2: |
| Whether the contract was for Sober Living Transitional Housing services to Veterans in communitybased facilities: |
| communitybased facilities: |
| A description providing details of the specific tasks the Offeror performed under that contract: |
| In what geographic location the Offeror performed: |
| example Los Angeles CA and Dallas TX: |
| these services: |
| The dates during which the Offeror performed the contract: |
| contract: |
| The number of patients to whom the Offeror provided Sober Living Transitional Housing services to Veterans in communitybased facilities: |
| services to Veterans in communitybased facilities: |
| Whether the Offeror was the prime contractor or a subcontractor for that contract: |
| Whether the Offeror was the prime contractor or a subcontractor for that contractRow1: |
| 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: |
| Reference Contract Worksheet: |
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