Past Performance Worksheet.xlsx

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Attached to
Underground Storage Tank (UST) Sump & Hydro Repair Testing
Solicitation number
36C24123Q1038
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 Solicitation Number 36C24123Q1038 for Underground Storage Tank (UST) Sump & Hydro Repair Testing services issued by 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 agency name, contract number, award and completion dates, value, type of contract, descriptions of work performed, points of contact, and major subcontractors.

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Other files

File Type Posted
LOS Certification.pdf PDF
36C24123Q1038.pdf PDF
SCA Wage Determination 2015-4047 Rev 24 6.30.2023.pdf PDF
Corrected 36C24123Q0628 UST Sump Repair and Hydro Testing_v1.xlsx XLSX spreadsheet

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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:

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