Relevant Experience Form Attachment 1.docx

DOCX document 19 KB Posted

Attached to
J066--Histology Lab Equipment Preventative Maintenance and Support Service for the Michael E. DeBakey VA Medical Center
Solicitation number
36C25624Q0763
Issued by

About this file

The provided document is a Relevant Experience Form, which is an attachment to a federal contract solicitation. The solicitation is for Histology Lab Equipment Preventative Maintenance and Support Service for the Michael E. DeBakey VA Medical Center, with a NAICS code of 811210 and a small business size standard of $34.0M. The solicitation is a Request for Quotation (RFQ) being issued as a Total (100%) Small Business Set-Aside, and the anticipated performance period is from May 1, 2024 to April 30, 2025, with four 12-month option periods. The Relevant Experience Form requires offerors to list their most recent relevant contracts, including the customer name, contact information, contract value, term, status, and a description of the scope of work. Offers are due by April 30, 2024, and all questions must be submitted by April 26, 2024.

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Other files

File Type Posted
STATEMENT OF WORK v2.doc DOC document
36C25624Q0763_2.docx DOCX document
36C25624Q0763_1.docx DOCX document
Past Performance Questionnaire Attachment 2.docx DOCX document

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Text version

Relevant Experience Form.

Please list your contracts in the chronological order beginning with the most recent one. Contracts shall be relevant to the Solicitation. Contracts listed cannot be more than 10 years old. You can list ongoing contracts that began more than 10 years ago.

Contract #1

1.Customer Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status ___Ongoing ___Completed

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Attachment 1: 36C25624Q0763

Contract #2

1.Customer Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #3

1.Customer Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

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