Exhibit C - Past Performance Summary Sheet FINAL.pdf
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- Attached to
- Clinical Reference Laboratory Testing Services
- Solicitation number
- HT001526RE001FINAL
- Issued by
-
Defense Health Agency
About this file
This is a template form for Past Performance Summary Sheets required in response to RFP HT001526RE001. The document provides a standardized format for offerors to document their relevant past performance references as part of Volume II of their proposal submission.
The form requires offerors to submit one summary sheet per past performance reference, with a maximum of two pages per project. Each sheet must include: company identification information (Company Name, CAGE code, UEI, and designation as prime or subcontractor); contract details (contract or task order number, period of performance, and contract type); current government points of contact from both the contracting office and customer organization with email addresses and phone numbers; description of relevancy including project location, scope of services, and complexity/magnitude; contract award amounts for base year and option years (Options 1-4); project status including performance reporting status and years successfully completed, along with any terminations or modifications; and pricing information showing both the price at award and final or projected final price. The form explicitly instructs offerors not to provide IDIQ basic contract numbers, but rather to reference the specific task order number under which work was completed. The template is repeated multiple times within the document to accommodate submission of multiple past performance references.
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Text version
Solicitation Number
RFP HT001526RE001
Exhibit C
Exhibit C – Past Performance Summary Sheet
Provide the following information for each past performance reference in accordance with RFP HT0015-26-R-E001 Instructions to Offerors for Volume II. Use one Summary sheet per past performance reference. Limit two (2) pages per project.
Company Name, CAGE, UEI, and Prime or Subcontractor:
Company Name:
CAGE:
UEI:
Prime or Subcontractor?
Contract Number or Task Order number, contract period of performance, and Contract Type:
Do not provide IDIQ basic contract numbers. Projects provided under an IDIQ shall reference the Task Order number from which the work was completed.
Contract Number:
Period of performance:
Contract Type:
Current point of contact (POC):
Provide current email address(es) and phone number(s). Provide two Government POCs if possible, one from the contracting office and one from the customer.
1.
2.
Description of relevancy:
Provide the scope, location of services, and the complexity/magnitude for this effort.
Location:
Description of Scope:
Description of Complexity and Magnitude:
Contract or Task Order Award Amount (Base and Options):
List the amount of the base year and each option year on the contract.
Base year:
Option 1:
Option 2:
Option 3:
Option 4:
Status of the project:
Identify status of performance reporting and how many years have successfully been completed. Identify any terminations or modifications for scope change.
Awarded Price and Final/Projected Final Price:
1. Price at award
2. Final or Projected Final Price:
Company Name, CAGE, UEI, and Prime or Subcontractor:
Company Name:
CAGE:
UEI:
Prime or Subcontractor?
Contract Number or Task Order number, contract period of performance, and Contract Type:
Do not provide IDIQ basic contract numbers. Projects provided under an IDIQ shall reference the Task Order number from which the work was completed.
Contract Number:
Period of performance:
Contract Type:
Current point of contact (POC):
Provide current email address(es) and phone number(s). Provide two Government POCs if possible, one from the contracting office and one from the customer.
1.
2.
Description of relevancy:
Provide the scope, location of services, and the complexity/magnitude for this effort.
Location:
Description of Scope:
Description of Complexity and Magnitude:
Contract or Task Order Award Amount (Base and Options):
List the amount of the base year and each option year on the contract.
Base year:
Option 1:
Option 2:
Option 3:
Option 4:
Status of the project:
Identify status of performance reporting and how many years have successfully been completed. Identify any
Company Name, CAGE, UEI, and Prime or Subcontractor:
Company Name:
CAGE:
UEI:
Prime or Subcontractor?
Contract Number or Task Order number, contract period of performance, and Contract Type:
Do not provide IDIQ basic contract numbers. Projects provided under an IDIQ shall reference the Task Order number from which the work was completed.
Contract Number:
Period of performance:
Contract Type:
Current point of contact (POC):
Provide current email address(es) and phone number(s). Provide two Government POCs if possible, one from the contracting office and one from the customer.
1.
2.
Description of relevancy:
Provide the scope, location of services, and the complexity/magnitude for this effort.
Location:
Description of Scope:
Description of Complexity and Magnitude:
Contract or Task Order Award Amount (Base and Options):
List the amount of the base year and each option year on the contract.
Base year:
Option 1:
Option 2:
Option 3:
Option 4:
Status of the project:
Identify status of performance reporting and how many years have successfully been completed. Identify any
| Status of the project Identify status of performance reporting and how many years have successfully been completed Identify any terminations or modifications for scope changeRow1: |
| Status of the project Identify status of performance reporting and how many years have successfully been completed Identify any terminations or modifications for scope changeRow1_2: |
| Status of the project Identify status of performance reporting and how many years have successfully been completed Identify any terminations or modifications for scope changeRow1_3: |
| Awarded Price and FinalProjected Final Price_3: |
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