HT941026QE007-Past Performance Summary Sheet.docx
DOCX document 25 KB Posted
- Attached to
- On-call, As-needed Interventional Cardiologist at Tripler Army Medical Center (TAMC), Hawaii
- Solicitation number
- HT941026QE007
- Issued by
-
Department of the Army Medical Command
About this file
This is a Past Performance Summary Sheet template for use by contractors responding to Solicitation HT941026QE007, a Request for Quotation (RFQ) for on-call, as-needed Interventional Cardiologist services at Tripler Army Medical Center (TAMC) in Hawaii. The template is designed to collect standardized past performance reference information from offerors and does not contain substantive details about the solicitation requirements themselves.
The form requires contractors to provide company identification (name and CAGE code), prime or subcontractor status, relevant contract or task order numbers with periods of performance, current points of contact with email and phone information, descriptions of effort including labor categories and FTE allocation, contract award amounts for base years and option periods, and project status including completion milestones and any terminations or scope modifications. This template is intended to support evaluation of contractor qualifications for the small business set-aside acquisition under current contract number W81K0221P0093, issued by the Department of the Army Medical Command.
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Other files
| File | Type | Posted |
|---|---|---|
| HT941026QE007-Past Performance Questionnaire.docx | DOCX document | |
| HT941026QE007.pdf |
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Text version
Past Performance Summary Sheet
Provide the following information for the past performance reference submitted in response to Solicitation HT941026QE007.
Company Name and CAGE:
Company Name:
CAGE:
Sub or Prime?
Contract Number or Task Order number and contract period of performance:
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:
Current point of contact (POC):
Provide current email address and phone numbers. Provide two POCs if possible, one from the contracting office and one from the end user/customer.
1.
2.
Description of effort:
Provide the labor categories, location of services and the number of FTEs performed for this effort.
Location:
Labor Category:
# of FTE:
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.
File details come from the government source that posted it. Updated .