Attachment_1_-_Past_Performance_Information_Sheet.docx

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Attached to
Medical Coding Services Federal contract opportunity
Solicitation number
N62645-16-R-0009
Issued by
Department of the Navy Bureau of Medicine and Surgery

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Solicitation Attachment 1 Past Performance Information Sheet

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Attachment 1—Past Performance Information Sheet

1. POC information to include name, title, phone number, e-mail address, agency name, and address:

2. Contract Number and Task Order number(s), if applicable:

3. Name of contractor to whom the contract was awarded. Provide the CAGE Code and DUNS numbers of the awardee:

4. Dates when services were provided:

5. Place(s) of performance:

6. List the number and type of medical administrative support workers provided. (i.e., Medical Clerical Support, Patient Administration Support Services, or Medical Records Support, etc.) Specify if services were full time, part time, temporary, or locum tenens types of services:

7. The contractor shall provide information on problems encountered on the identified contract(s) and the contractor’s corrective actions:

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