7_Atch_4__PPRL.pdf

Attachment 4 Solicitation No. FA520919U0035

PAST PERFORMANCE REFERENCE LIST

LICENSED PRACTICAL NURSE FOR TRICARE OPERATIONS & PATIENT ADMINISTRATION (TOPA)

374TH MEDICAL GROUP YOKOTA AIR BASE, JAPAN

1. Name of contracting activity (your customer)

2. Name and title of point of contact (POC);

Contracting Officer or/and Government Inspector/commercial project manager’s phone/Fax number, and e-mail address

Tel:

Fax:

e-mail:

3. Contract number and project title

4. Contract Type (e.g. Firm-Fixed Price, IDIQ, Requirements type)

5. Total contract value (annual)

6. Performance period (e.g. date/month/year through date/month/year)

7. Description of contract work performed

Details

8. Contracting Officer’s name and phone number

9. Government Inspector/commercial project manager and phone number

10. List of major subcontractors if applicable

OFFEROR’S NAME (Company Name): _______________________________________________________________