D.6 Past Performance References.pdf
PDF 171 KB Posted
- Attached to
- Q515--ON-SITE/OFF-SITE Pathology Services/589A7
- Solicitation number
- 36C25525Q0096_1
About this file
This is a past performance reference template form for RFQ 36C25525Q0096 for On-Site/Off-Site Pathology Services. The form requires offerors to provide three references from organizations where they have provided on-site/off-site pathology services within the last 24 months. For each reference, vendors must include the organization name and address, point of contact details (name, email, phone, title), and a brief description of services provided along with the period of performance.
This template is associated with a VA Medical Center solicitation in Wichita, KS for an IDIQ firm-fixed-price contract spanning one base year (07/01/2025 - 06/30/2026) with four one-year options. The form itself is a standard template that does not contain any completed reference information, only blank fields for offerors to complete.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| D.2 Quality Assurance Surveillance Program QASP.docx | DOCX document | |
| D.3 Contractor Rules of Behavior.pdf | ||
| D.8 BYLAWS Robert J Dole VAMC June 2023.pdf | ||
| D.1 Price Schedule.xlsx | XLSX spreadsheet | |
| D.7 Wage Determination 2015-5341 rev 27 7-22-2024.docx.pdf | ||
| 36C25525Q0096_1.docx | DOCX document | |
| D.5 Immigration and Nationality Act.pdf | ||
| D.4 Organizational Conflict of Interest.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
PAST PERFORMANCE REFERENCES
Reference Request For Quotation (RFQ) 36C25525Q0096; On-Site/Off-Site Pathology Services
Offerer:_______________________________________________________________________
Provide three (3) references with On-site/Off-site Pathology Services within the last 24 months.
Thank you.
REFERENCE 1 INFORMATION
ORGANIZATION NAME AND
ADDRESS
POINT OF CONTACT
Name:
Email:
Phone:
Title:
BRIEF DESCRIPTION OF SERVICES PROVIDED & PERIOD OF PERFORMANCE
REFERENCE 2 INFORMATION
ORGANIZATION NAME AND
ADDRESS
POINT OF CONTACT
Name:
Email:
Phone:
Title:
BRIEF DESCRIPTION OF SERVICES PROVIDED & PERIOD OF PERFORMANCE
REFERENCE 3 INFORMATION
ORGANIZATION NAME AND
ADDRESS
POINT OF CONTACT
Name:
Email:
Phone:
Title:
BRIEF DESCRIPTION OF SERVICES PROVIDED & PERIOD OF PERFORMANCE
PAST PERFORMANCE REFERENCES
Reference Request For Quotation (RFQ) 36C25525Q0096; On-Site/Off-Site Pathology Services
| PAST PERFORMANCE REFERENCES |
| D.6 Past Performance Questionnaire_PG comments.pdf |
| PAST PERFORMANCE QUESTIONNAIRE |
| Offerer: |
| ORGANIZATION NAME AND ADDRESSRow1_2: |
| Name_2: |
| Email_2: |
| Phone_2: |
| Title_2: |
| BRIEF DESCRIPTION OF SERVICES PROVIDED PERIOD OF PERFORMANCERow1_2: |
| ORGANIZATION NAME AND ADDRESSRow1_3: |
| Name_3: |
| Email_3: |
| Phone_3: |
| Title_3: |
| BRIEF DESCRIPTION OF SERVICES PROVIDED PERIOD OF PERFORMANCERow1_3: |
| ORGANIZATION NAME AND ADDRESSRow1: |
| Name: |
| Email: |
| Phone: |
| Title: |
| BRIEF DESCRIPTION OF SERVICES PROVIDED PERIOD OF PERFORMANCERow1: |
File details come from the government source that posted it. Updated .