S02 - Attachment D.5 Past Performance Reference.pdf
PDF 83 KB Posted
- Attached to
- Q501--Anesthesiology Services Federal contract opportunity
- Solicitation number
- 36C25623Q1573
About this file
This document contains a past performance reference template for solicitation 36C25623Q1573 for anesthesiology services. The template includes fields for contractors to provide three references including the name, address, contract number, description of work, whether the contractor served as a prime or subcontractor, dates of performance, total cost, and information on incentives, deductions, or terminations for cause. Contractors will use this template to submit details of relevant prior contracts demonstrating their experience and past performance for the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16's requirement for anesthesiology services. The solicitation number, agency name, and opportunity type are also provided to identify the related federal contract opportunity.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 0001 - RFQ 36C25623Q1573 - Anesthesiologist and CRNA.pdf | ||
| 36C25623Q1573_1.docx | DOCX document | |
| S02 - Attachment D.3 - VAAR 852.219-75 VA Notice of Limitations on Subcontracting.pdf | ||
| S02 - RFQ 36C25623Q1573 - Physician Anesthesiologist and CRNA - Houston.pdf | ||
| 36C25623Q1573.docx | DOCX document | |
| S02 - Attachment D.2 Wage Determination.pdf | ||
| S02 - Attachment D.1 QASP.pdf | ||
| S02 - Attachment D.4 _ Business Associate Agreement.pdf |
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Text version
ATTACHMENT D.5 - Past Performance
RFQ - 36C25623Q1573
– 36C25623Q0090 Registered Nurse Services
SERVICES
PAST PERFORMANCE 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 .