S02 Relevant Experience Form-Attachment A.docx

DOCX document 19 KB Posted

Attached to
R410--RFQ- Magnet Readiness Service Federal contract opportunity
Solicitation number
36C25622Q0519
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

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Other files attached to R410--RFQ- Magnet Readiness Service, newest first.
File Type Posted
36C25622Q0519 0001.docx DOCX document
S02-36C25622Q0519-Magnet Services.pdf PDF
S02 WD REV 20-Attachment B.pdf PDF
36C25622Q0519_1.docx DOCX document

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ATTACHMENT A

RELEVANT EXPERIENCE FORM

Please list your contracts in the chronological order beginning with the most recent one. Contracts listed cannot be more than 5 years old. You can list ongoing contracts that began more than 5 years ago.

Contract #1

1.Customer Name
2. Customer’s Address
3.Name and Title of Contact Point
4.Contact Point’s Email Address
5.Contact Point’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status ___Ongoing ___Completed

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Request For Quote documents. Attach separate sheet if additional space is needed.)

36C25622Q0519

Contract #2

1.Customer Name
2. Customer’s Address
3.Name and Title of Contact Point
4.Contact Point’s Email Address
5.Contact Point’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Request For Quote documents. Attach separate sheet if additional space is needed.)

Contract #3

1.Customer Name
2. Customer’s Address
3.Name and Title of Contact Point
4.Contact Point’s Email Address
5.Contact Point’s Phone Number
6.Estimated Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in details the scope of works performed under this contract as indicated in the Request For Quote documents. Attach separate sheet if additional space is needed.)

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