S02 - Attachment D8 - Past Performance Reference.pdf

PDF 72 KB Posted

Attached to
Q522--Teleradiology Services Gulf Coast Veterans Health Care System
Solicitation number
36C25625Q0797
Issued by

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This document is a Past Performance References form for RFQ 36C25625Q0797, which is part of a solicitation for Teleradiology Services at the Gulf Coast Veterans Health Care System. The form provides a structured template for vendors to document three separate past performance references, with fields for:

  • Organization name and address
  • Contract number
  • Brief contract description
  • Contractor role (Prime or Sub-Contractor)
  • Performance dates
  • Total contract cost
  • Termination status
  • Point of contact information including name, title, phone, and email
  • Additional comments

The form allows potential contractors to demonstrate their previous experience by providing detailed information about prior contracts, which will likely be used to evaluate the vendor's qualifications and performance history for the teleradiology services opportunity.

View the file

Other files

File Type Posted
Amendment 0001 - RFQ 36C25625Q0797 - Teleradiology GCVHCS.pdf PDF
S02 - Attachment D3 - Contractor Rules of Behavior.pdf PDF
S02 - RFQ 36C25625Q0797 - Tele Rad Biloxi.pdf PDF
S02 - Attachment D2 - CPT Codes.xlsx XLSX spreadsheet
36C25625Q0797.docx DOCX document
S02 - Attachment D5 - Contractor Certification Immigration and Nationality Act of 1952.pdf PDF
S02 - Attachment D6 - Conflict of Interest.pdf PDF
S02 - Attachment D4 - VAAR 852.219-75.pdf PDF
S02 - Attachment D1 - QASP GCVHCS.pdf PDF
S02 - Attachment D7 - VHA Teleradiology Handbook.pdf PDF

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ATTACHMENT D.8 - Past Performance References, Teleradiology, RFQ - 36C25625Q0797

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 .