Past Performance Worksheet.xlsx

17 KB Posted

Attached to
H312--Fire Extinguisher Inspection and Maintenance Services
Solicitation number
36C24126Q0234
Issued by

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This is a Past Performance Worksheet template designed to collect historical contract performance information from bidders responding to federal solicitations. The form requires submission of three past performance references (REF #1, REF #2, and REF #3), with each reference requesting comprehensive details about previously completed contracts. For each reference, bidders must provide the contracting activity name and agency, contract number, award date, performance period (beginning and completion dates), total contract value, contract type, technical and contracting points of contact with full contact information, place of performance, detailed description of work performed, any commendations or awards received, and a list of major subcontractors. The template specifically includes a pre-filled reference indicating preventative maintenance work performed for the Department of Veterans Affairs, suggesting this worksheet is being used in connection with the H312 Fire Extinguisher Inspection and Maintenance Services solicitation for the Providence VA Medical Center.

This worksheet is part of the evaluation criteria for solicitation 36C24126Q0234, a Veteran-Owned Small Business (VOSB) set-aside for fire extinguisher inspection and maintenance services at a VA Medical Center. The solicitation is issued as an RFQ under FAR streamlined procedures for commercial services, with the NAICS code 541350 (Building Inspection Services) and a small business size standard of $11.5 million. Bidders are required to demonstrate past performance capability through documented examples of similar work, with references serving as validation of technical competence, organizational capacity, and successful delivery of preventative maintenance and inspection services to government agencies.

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Other files

File Type Posted
36C24126Q0234 0001.pdf PDF
WD 2015-4045 - Hyannis Rev34.pdf PDF
LOS certification.pdf PDF
WD 2015-4063 - NB Rev33.pdf PDF
36C24126Q0234.docx DOCX document
WD 2015-4083 - RI Rev32.pdf PDF
Safety extinguisher tracker.xlsx XLSX spreadsheet

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REF #1

1. Name of Contracting Activity, Government Agency, Commerical Firm or other Organization: Preventative Maintenance, Department of Veterans Affiars
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 .