Past Performance Questionnaire.docx
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- Solicitation number
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This document includes a sources sought notice and draft statement of work for pharmacy automated packaging and dispensing systems. The Great Plains Area Indian Health Service is seeking information from small businesses interested in providing pharmacy robotic systems and ongoing maintenance for multiple hospitals, health centers and clinics in North and South Dakota. Interested parties should provide organizational details, capability statements addressing the requirements, past performance information using the attached questionnaire, and notice of applicable GSA schedules or procurement vehicles. Responses are due by October 18th, 2022. Based on the responses received, the requirement may be set aside for Indian economic enterprises, Indian small business economic enterprises, or total small businesses, or procured through full and open competition using a firm fixed-price contract awarded on an all-or-none basis.
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Other files
| File | Type | Posted |
|---|---|---|
| IHS IEE Representation Form_Jan 2022_508 Compliant.pdf | ||
| 06-PWS - Pharmacy Dispensing System-R2.0-0.28.2022.docx | DOCX document |
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Pharmacy Automated Packaging / Dispensing
PAST PERFORMANCE QUESTIONNAIRE
1. Contract Number: ____________________________________________
2. Indicate whether you were the prime contractor or subcontractor.
[ ] Prime Contractor [ ] Subcontractor
3. Contract Award Period:_________________________________________
4. Contract Type (e.g., Fixed-Price, Cost-Reimbursement, etc.)
5. Contract Term (e.g., One Year, Base Year and Options).
6. Contract Dollar Value:__________________________________________
7. Name of Procuring Organization:
8. Address of Procuring Organization:
9. Contracting Officer’s Name and Phone Number:
10. Program Manager or COTR’s Name and Phone Number:
11. Provide information on problems encountered on the identified contract and the corrective action taken.
12. Provide a brief summary of the work accomplished and how it relates to the work required by this solicitation.
Sources Sought Notice
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