S02 D.7 Experience Worksheet.docx
DOCX document 34 KB Posted
- Solicitation number
- 36C25724Q0105
About this file
This document contains a worksheet for contractors to provide experience information related to Federal Solicitation Number 36C25724Q0105 for Interventional Cardiology and Electrophysiology Services. Contractors must provide details of previous contracts held with Federal, state or local government agencies or private entities to deliver similar cardiology services. For each past contract, the contractor will list the contract number, dates of service, description of services performed, geographic location of services, and contact information for a reference at the contracting agency who can verify the contract details. The worksheet collects this experience information to assess contractor qualifications for the interventional cardiology and electrophysiology services being solicited by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17.
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Other files
| File | Type | Posted |
|---|---|---|
| S06 36C25724Q0105 0001.docx | DOCX document | |
| S02 D.6 Organizational Conflicts of Interest.docx | DOCX document | |
| S02 D.5 Contractor Certification - Immigration and Nationality Act.docx | DOCX document | |
| S02 D.2 Background Investigation Forms.docx | DOCX document | |
| S02 D.4 Contractor Rules of Behavior.docx | DOCX document | |
| S02 D.1 Quality Assurance Surveillance Plan.docx | DOCX document | |
| S02 D.3 STVHCS COVID-19 Guidelines.docx | DOCX document | |
| 36C25724Q0105.docx | DOCX document |
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Text version
D.7 Experience Contract Worksheet Experience Contract #____________
| The legal name of the entity with whom the Quoter held the contract(s)/BPA(s)/task order(s) for Cardiology, Interventional Cardiology and Electrophysiology Physician Services. |
| (example: Veterans Affairs, LA City Department of Public Health) |
When the contract(s)/BPA(s)/task order(s) with a Federal, State, local government, or private agency under which you provided the same or similar services required in this solicitation was started and concluded
Contract Number
A detailed description providing details of the specific tasks the Quoter performed under the contract(s)/BPA(s)/task order(s) that was for Cardiology, Interventional Cardiology and Electrophysiology Physician Services
| The geographic location where Quoter performed these services. |
| (example: Los Angeles county, New York City) |
The name, phone number, and email address of a person at the entity with whom the Quoter held the contract(s)/BPA(s)/task order(s) who can verify the information the Quoter provides in the narrative description for this contract
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