D.3 PAST PERFORMANCE REFERENCES.rtf

RTF text file 232 KB Posted

Attached to
R499--Patient Satisfaction Surveys Federal contract opportunity
Solicitation number
36C25722Q0744
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17

About this file

Written by GovTribe AI ·

This document contains a template for submitting past performance references for solicitation 36C25722Q0744 for patient satisfaction surveys from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17. The template includes sections for three references with fields to include the name of the organization, address, contract number, description of work performed, dates of performance, total value, and contact information. Offerors are asked to indicate if they served as a prime contractor or subcontractor for each reference and to note any contract terminations for default or discrepancy reports filed.

Text of this file

D.3 ATTACHMENT 36C25722Q0744 – 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:

Other files for this federal contract opportunity

Other files attached to R499--Patient Satisfaction Surveys, newest first.
File Type Posted
S02 36C25722Q0744 v2.pdf PDF
D.2 WAGE DETERMINATION DFW.pdf PDF
D.1 QUALITY ASSURANCE SURVEILLANCE PLAN.docx DOCX document

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