About this file

This is a Key Personnel Roster template for federal contract 36C25527Q0002. The form is designed to capture information about key personnel assigned to the contract and includes columns for Name, NPI (National Provider Identifier), Clinic assignment, and On-Call status. The template contains nine blank rows for personnel entries, with checkboxes under the Clinic and On-Call columns to designate whether each individual is assigned to clinic duties, on-call responsibilities, or both. The document does not contain populated data, pricing information, performance requirements, or other substantive contract details; it serves solely as a blank template for contractor submission of key personnel information.

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Text version

D.5 Key Personnel Roster 36C25527Q0002

NAME NPI CLINIC ON-

CALL

NAMERow1:
NPIRow1:
NAMERow2:
NPIRow2:
NAMERow3:
NPIRow3:
NAMERow4:
NPIRow4:
NAMERow5:
NPIRow5:
NAMERow6:
NPIRow6:
NAMERow7:
NPIRow7:
NAMERow8:
NPIRow8:
Check Box19: Off
Check Box20: Off
Check Box21: Off
Check Box22: Off
Check Box23: Off
Check Box24: Off
Check Box25: Off
Check Box26: Off
Check Box27: Off
Check Box28: Off
Check Box29: Off
Check Box30: Off
Check Box31: Off
Check Box32: Off
Check Box33: Off
Check Box34: Off

File details come from the government source that posted it. Updated .