PAST PERFORMANCE QUESTIONNAIRE.pdf
PDF 393 KB Posted
- Attached to
- ENT Services Federal contract opportunity
- Solicitation number
- CRHC21-12
About this file
This solicitation is seeking proposals for ENT (ear, nose, and throat) services. The Indian Health Service/Cheyenne River Health Center intends to award a firm fixed-price, non-personal services contract to provide ENT specialty services at the Outpatient Department of the Cheyenne River Health Center in Eagle Butte, South Dakota. The period of performance is one base year plus four one-year options from July 1, 2021 through June 30, 2026. This is an IEE small business set-aside with a NAICS code of 621111 and size standard of $12 million. Proposals are due by April 14, 2021 and shall include technical and cost volumes, references, and past performance questionnaires. Evaluation will consider technical approach, management plan, and relevant past performance as the most important factors with cost or price less important. The solicitation number is CRHC21-12.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| CRHC21-12 UCF.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
1. Contract
Number:________________________________________________________________
2. Indicate whether you are 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(aggregated):_____________________________________________________
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 brief summary of the work accomplished and how it relates to the work required by this solicitation.
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