S02 D.4 Past Performance Questionnaire Worksheet - Locum GI Physician Services.docx
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- Solicitation number
- 36C25726Q0159
About this file
This is a Past Performance Questionnaire Worksheet for quoters responding to RFQ 36C25726Q0159 for Locum Gastroenterology (GI) Physician Services. The worksheet is designed to evaluate Factor 2 (Past Performance) of vendor proposals and assesses a quoter's likelihood of performing successfully on the contract based on relevancy, recency, and confidence/success of prior work.
The questionnaire requires quoters to provide detailed information about relevant past performance contracts, including the legal name of entities with whom gastroenterology physician services were provided, whether the work was performed for federal, state, local, or private agencies within the last three years, contract numbers, performance dates, and geographic locations. Additionally, quoters must submit a contact person's name, phone number, and email address from the previous contracting entity who can verify the information provided. The worksheet also requires quoters to describe their Quality Control Plan for meeting contract requirements and performance standards, as well as a contingency plan for replacing key personnel to maintain service continuity under the contract terms. The solicitation is issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17 for Locum GI Physician Services (MSO-2026-COM-0017).
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RFQ 36C25726Q0159 – Locum GI Physician Services
D.4 Past Performance Questionnaire Worksheet
Factor 2 – Past Performance – This factor will be used to assess a quoter’s likelihood of performing successfully on this contract. Past performance will be assessed for relevancy, recent, and confidence/success.
The legal name(s) of the entity(ies) with whom the Quoter held the contract for Gastroenterology Physician Services.
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Was the contract with a Federal, State, local government, or private agency under which you have provided the same or similar services required in this solicitation within the last three (3) years.
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The name, phone number, and email address of a person at the entity with whom the Quoter held this contract who can verify the information the Quoter provides in the narrative description for this contract.
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Contract Number(s)
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The dates during which the Quoter performed the Gastroenterology Physician Services.
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In what geographic location did the Quoter provide the Gastroenterology Physician Services.
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Quality Control Plan: Description and reporting reflecting the Quoter’s plan for meeting contract requirements and performance standards.
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Contingency plan for replacing key personnel to maintain services as required under the terms of the contract.
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File details come from the government source that posted it. Updated .