Past Performance Worksheet.xlsx

XLSX spreadsheet 16 KB Posted

Attached to
G004--Station 631 HCHV Medical Respite Care services
Solicitation number
36C24123Q0820
Issued by

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This document contains a past performance worksheet template for federal contractors to provide references from up to three previous government contracts or commercial projects relevant to the requirements of solicitation number 36C24123Q0820 for G004--Station 631 HCHV Medical Respite Care services from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1. The template includes fields for contractors to provide details of previous contracts such as contract number, award and completion dates, value, type of contract, place of performance, description of work, commendations or awards received, major subcontractors if any, and contact information for technical and contracting points of contact from the contracting activity.

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REF #1

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization:
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

REF #2

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization:
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

REF #3

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization:
2. Contracting Activity Address:
3. Contract Number:4. Date of Contract Award:
5. Beginning Date of Contract:6. Completion Date of Contract:
7. Contract Value:8. Type of Contract:
9a. Technical Point of Contact:9b. Contracting Point of Contact:
Name:Name:
Title:Title:
Address:Address:
Telephone:Telephone:
Email:Email:
10. Place of Performance:
11. Description of Work (Use a continuation sheet if necessary):
12. List any commendations or awards received:
13. List of Major Subcontractors:

File details come from the government source that posted it. Updated .