D.4 Reference Contract Worksheet Demonstrating VA Experience.docx
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- Q401--Veterans Affairs Loma Linda Healthcare System (VALLHS) Nurse Staffing Services Amendment 0003
- Solicitation number
- 36C26223R0067
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D.4 Reference Contract Worksheet Demonstrating VA Experience
The information collected by this Worksheet will be used to evaluate proposals for STEP 1 of proposal evaluations. Offerors submitting proposals to provide nurse staffing services for this procurement must complete the below Table demonstrating that Offeror (or Offeror’s proposed subcontractor) has experience providing nursing staff in each of the nurse specialties required for this procurement and that Offeror (or Offeror’s proposed subcontractor) has provided these staffing services to the U.S. Department of Veterans Affairs. Offerors are only required to provide one reference contract for each nursing specialty. Offerors must complete each Table entry.
Reference Contract Worksheet Demonstrating Offeror’s (or Offeror’s proposed subcontractor’s) Experience Providing Nurse Staffing Services to the U.S. Department of Veterans Affairs
| Nursing Specialty |
| VA Medical Center Where Services are / were Provided |
| VA Contract Number |
| Period of Performance |
| Point of contact (name, phone and email) for verification |
Nurse Practitioner
Registered Nurse - General
Registered Nurse - Specialty
Licensed Vocational Nurse
Certified Nurse Assistant
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