S02 D.6 Experience Worksheet.docx
DOCX document 24 KB Posted
- Attached to
- G004--Temporary Shelter HCHV Service (STX)
- Solicitation number
- 36C25723Q0664
About this file
This document is an experience worksheet template for offerors responding to solicitation number 36C25723Q0664 from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17 for temporary shelter and homeless services. The worksheet collects details on previous relevant contracts held by the offeror or proposed subcontractors, including the legal name of the contracting entity, contract number, type of services provided such as case management or transitional housing, location and dates of performance, average monthly number of clients served, whether the reference contract is for the offeror or subcontractor's past performance as a prime contractor or subcontractor, and references for verification. The template collects this experience data to evaluate offerors' past performance qualifications for providing the temporary shelter and homeless services required by the solicitation.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C25723Q0664 0002.docx | DOCX document | |
| 36C25723Q0664 0001.docx | DOCX document | |
| S02 D.5 Organizational Conflicts of Interest.docx | DOCX document | |
| S02 D.1 Quality Assurance Surveillance Plan QASP.docx | DOCX document | |
| 36C25723Q0664_1.docx | DOCX document | |
| S02 D.3 Contractor Rules of Behavior.docx | DOCX document | |
| S02 D.4 Contractor Certification - Immigration and Nationality Act.docx | DOCX document | |
| S02 D.2 Wage Determination 2015-5253 Rev 21.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
D.5 Experience Contract Worksheet Experience Contract #____________
| The legal name of entity with whom the Offeror (or Offeror’s proposed subcontractor) held the contract |
| (example: Veterans Affairs, LA City Department of Public Health) |
Contract Number
| Whether the contract was for case management services or transitional housing services, or both, to people experiencing homelessness. |
| Case Management Services (Yes / No) |
Transitional Housing Services (Yes / No)
A description providing details of the specific tasks the Offeror (or Offeror’s proposed subcontractor) performed under that Contract
| In what geographic location the Offeror (or Offeror’s proposed subcontractor) performed these services |
| (example: Los Angeles county, New York City) |
The dates during which the Offeror (or Offeror’s proposed subcontractor) performed the contract
The average monthly number of people experiencing homelessness to whom the Offeror (or Offeror’s proposed subcontractor) provided case management services or transitional housing services, or both, under this contract.
Case management services were provided to __________ people experiencing homelessness on average per month
Transitional housing services were provided to __________ people experiencing homelessness on average per month
Whether the provided reference contract is for services provided by the Offeror or provided by a proposed subcontractor of the Offeror’s
Whether the Offeror or its proposed subcontractor was the prime contractor or a subcontractor for that provided reference contract.
The name, phone number, and email address of a person at the entity with whom the Offeror (or Offeror’s proposed subcontractor) held this contract who can verify the information the Offeror provides in the narrative description for this contract.
Page 1 of
File details come from the government source that posted it. Updated .