S02 - Attachment 3 _ Past Performance References.pdf

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Attached to
36C25626Q0007 Gulf Coast Medical Physicist and Radiation Safety Officer Services
Solicitation number
36C25626Q0007
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This document is an Experience Reference form for Solicitation No. 36C25623Q0090 for Registered Nurse Services. The form provides a template for contractors to document their past performance references, with space for three separate references. Each reference section requires detailed information including the organization name, contract number, performance dates, total contract cost, contractor role (prime or sub-contractor), point of contact details, and requires confirmation of any contract terminations. The form is designed to allow potential contractors to demonstrate their relevant experience and past performance in providing registered nurse services to government or commercial organizations.

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ATTACHMENT 3 D.3 EXPERIENCE REFERENCE

– 36C25623Q0090 Registered Nurse Services

Experience References

REFERENCE 1:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 2:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 3:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

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