D.7 Past Performance References.docx
DOCX document 16 KB Posted
- Solicitation number
- 36C25623R0008
About this file
This document contains a past performance reference template for a federal contractor to submit with their proposal. It requests information on up to three previous contracts including the client name and address, contract number, brief description of work performed, whether the work was as a prime contractor or subcontractor, dates of performance and contract value. It also asks if the contract had any terminations for cause or default and whether any contract discrepancy reports were filed. For each reference, it requests the point of contact's name, title, phone number, email address and optional comments.
The related federal contract opportunity is a solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 to provide onsite emergency medicine physicians and advance practice providers at the VAMC in Houston, TX. The solicitation number and additional details on the type of opportunity and contracting agency are provided.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25623R0008 0002.pdf | ||
| 36C25623R0008 0001.pdf | ||
| D.5 Organizational Conflict of Interest.docx | DOCX document | |
| 36C25623R0008.docx | DOCX document | |
| D.1 Quality Assurance Surveillance Plan (QASP).pdf | ||
| D.2 SAM.gov User Guide.pdf | ||
| D.10 Frequently Asked Questions.docx | DOCX document | |
| D.6 Immigration and Nationality.docx | DOCX document | |
| D.9 Information Security Rules of Behavior.pdf | ||
| D.3 E-verify Job Aid.pdf | ||
| D.4 Bylaws-and-Rules-VHA-MEDVAMC-July-22-2022-updated-signed.pdf | ||
| D.8 Past Performance Questionnaire.rtf | RTF text file |
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Text version
Attachment D.7 – Past Performance References
Reference 1:
Name of Government or Private Organization: _______________________________________ Address: ____________________________________________________________________ Contract number: ___________________________________________ Brief Description: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contractor Performed as: Prime contractor Sub-contractor Dates of Performance (if current include expiration date): ______________________________ Total Value of the Contract: ________________________________________ Any terminations for cause or default? Circle Yes or No If yes, briefly explain: __________________________________________________________ Any contract discrepancy reports filed? Circle Yes or No If yes, briefly explain: __________________________________________________________ Point of contact/COR name: _________________________ Title: ____________________________________ Telephone number: __________________________ Point of contact/COR e-mail address: _________________________ Comments:
Reference 2:
Name of Government or Private Organization: _______________________________________ Address: ____________________________________________________________________ Contract number: ___________________________________________ Brief Description: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contractor Performed as: Prime contractor Sub-contractor Dates of Performance (if current include expiration date): ______________________________ Total Value of the Contract: ________________________________________ Any terminations for cause or default? Circle Yes or No If yes, briefly explain: __________________________________________________________ Any contract discrepancy reports filed? Circle Yes or No If yes, briefly explain: __________________________________________________________ Point of contact/COR name: _________________________ Title: ____________________________________ Telephone number: __________________________ Point of contact/COR e-mail address: _________________________ Comments:
Reference 3:
Name of Government or Private Organization: _______________________________________ Address: ____________________________________________________________________ Contract number: ___________________________________________ Brief Description: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contractor Performed as: Prime contractor Sub-contractor Dates of Performance (if current include expiration date): ______________________________ Total Value of the Contract: ________________________________________ Any terminations for cause or default? Circle Yes or No If yes, briefly explain: __________________________________________________________ Any contract discrepancy reports filed? Circle Yes or No If yes, briefly explain: __________________________________________________________ Point of contact/COR name: _________________________ Title: ____________________________________ Telephone number: __________________________ Point of contact/COR e-mail address: _________________________ Comments:
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