Past Performance Questionnaire.docx

DOCX document 12 KB Posted

Attached to
MKDR Xpress Mobile X-Ray System for the Crow Service Unit Federal contract opportunity
Solicitation number
75H709-CR23Q-005
Issued by
Department of Health and Human Services Indian Health Service

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Other files attached to MKDR Xpress Mobile X-Ray System for the Crow Service Unit, newest first.
File Type Posted
B11 - IEE Representation.pdf PDF
75H709-CR23Q-005 Konica Mino Port XRay.pdf PDF
Attachment A mKDR Xpress Specs.pdf PDF

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Past Performance Questionnaire

1. Contract Number(s): _________________________________________________________________

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 COR'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.

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