19-PAST PERFORMANCE QUESTIONNAIRE.pdf

PDF 265 KB Posted

Attached to
Manor ISD - 2026 Medical RFP
Solicitation number
26-010RFP – RE-ISSUED
Issued by
Travis County, Texas

About this file

This is a Past Performance Questionnaire document for the Manor Independent School District's 2026 Medical RFP (RFP 26-010RFP - RE-ISSUED), located in Manor, Texas. Proposers must submit reference questionnaire packages for each project listed as a Past Performance evaluation factor, with a minimum of three preferred references from current customers outside of Manor ISD, including Educational Agencies (K-12 preferred), Government Agencies, and firms substantially serviced by the proposer. References must be most similar to Manor ISD. References are responsible for independently completing the questionnaire and submitting it directly to Chrissie Bryant, Purchasing Coordinator, at purchasing@manorisd.net by Thursday, April 30, 2026, at 2:00 PM (CT). The questionnaire must be submitted on company letterhead and emailed from a corporate email account. Proposers are responsible for following up with their references to ensure timely submission.

The questionnaire evaluates contractor performance across multiple criteria including service type provided, work timing, quality of services and goods, alignment with expectations, timeliness of completion, and recommendation for future work. References provide an overall rating using five performance levels: Exceptional (exceeds most contractual requirements with few minor issues), Very Good (exceeds some requirements with few minor issues), Satisfactory (meets contractual requirements with minor issues), Marginal (meets some requirements with significant problems), and Unsatisfactory (does not meet contractual requirements). This RFP is a re-issue of a previously advertised procurement in which the District rejected all prior proposals to ensure best value and adequate competition. All proposal responses must be uploaded to Euna only, with no hard copies accepted.

View the file

Other files

File Type Posted
3-EDGAR CERTIFICATIONS FORM rev 11.17.2020.pdf PDF
4-FORM A – COMPANY INFORMATION.pdf PDF
10-Manor Independent School District TX370294 BA0004 HMO Final SBC 09012025.pdf PDF
8-Manor Independent School District TX370294 BA0001 PPO Final SBC 09012025.pdf PDF
27-FORM C - Manor ISD - Medical RFP Workbook.xlsx XLSX spreadsheet
9-Manor Independent School District TX370294 BA0002 HSA Final SBC 09012025.pdf PDF
11-Manor ISD HMO SPD 09012025.pdf PDF
13-Manor ISD PPO SPD 09012025.pdf PDF
12-Manor ISD HSA SPD 09012025.pdf PDF
18-Manor Professional Provider 2025.xlsx XLSX spreadsheet
24-Manor ISD - 2026 Medical RFP - Addendum No. 1 - 3-2-26pdf (1).pdf PDF
26-Manor ISD PvC - 9.2025-3.2026.xlsx XLSX spreadsheet
20-26-010RFP - RE-ISSUED MANOR ISD - 2026 MEDICAL RFP - advertisement.pdf PDF
6-W9.pdf PDF
25-Manor ISD Large Claim Reporting - 9.2025-3.2026.xlsx XLSX spreadsheet
22-Manor ISD - Top 20 HCC 50K - 1.2025-12.2025 (1).pdf PDF
1-ACKNOWLEDGEMENT OF ADDENDA.pdf PDF
15-Manor ISD Large Claim Reporting 9.2023-12.2025.xlsx XLSX spreadsheet
5-FORM B – PRICING AND SERVICE AFFIRMATION.pdf PDF
7-Vendor Certification Form.pdf PDF
16-Manor ISD Medical Enrollment by Month 9.2023-12.2025.xlsx XLSX spreadsheet
21-Manor ISD - Medical Census 02012026v2 (1).xlsx XLSX spreadsheet
17-Manor ISD PvC 9.2023-12.2025.xlsx XLSX spreadsheet
14-Manor ISD Inpatient Provider 2025.xlsx XLSX spreadsheet
2-CIQ (CONFLICT OF INTEREST QUESTIONAIRE).pdf PDF
23-Manor ISD - NDC Claim Summary 2024-2025 (1).xlsx XLSX spreadsheet
28-26-010RFP - RE-ISSUED Manor ISD - 2026 Medical RFP.docx DOCX document
Show all 27

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

Page | 34

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and send a reference questionnaire package for each project you list as a reference for the Past Performance evaluation factor. The instructions page is to be omitted from the package when sending to references for completion.

The past performance questionnaire must be independently completed by the offeror’s client references. Offerors are responsible for ensuring that their client references complete this questionnaire and submit it via email directly to Manor ISD’s Purchasing department via email by the designated date and time listed on the questionnaire.

A list of at least three (3) preferred references from current customers outside of Manor ISD. References must include Educational Agencies (K-12 preferred), Government Agencies and/or firms, which are substantially serviced by the Proposer (references most similar to Manor ISD must be provided).

It is the Offeror’s responsibility to follow-up and to encourage references to send in their questionnaire.

PAST PERFORMANCE QUESTIONNAIRE

RFP 26-010RFP - RE-ISSUED, Manor ISD - 2026 Medical RFP

Please complete this Questionnaire and e-mail to Chrissie Bryant, Purchasing Coordinator

E-mail: purchasing@manorisd.net

________________________________ is currently in the process of preparing a proposal response for (Proposer Name) the Manor Independent School District RFP 26-010RFP - RE-ISSUED, Manor ISD - 2026 Medical RFP.

As part of our proposal, we have listed you as a reference on our performance for this type of service with your company/agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail to Chrissie Bryant, Purchasing Coordinator, at purchasing@manorisd.net.

Questionnaire is due no later than Thursday, April 30, 2026 at 2:00 PM (CT). Questionnaire must be submitted directly to the Purchasing Coordinator on company letterhead and emailed from a corporate e-mail account.

Thank you.

NAME OF PROPOSER: _________________________________________________

Phone: _________________ E-Mail: _________________

I. Past/Current Reference Information

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance: ________________________________________________________

4. Brief description of items provided:

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________ mailto:claudia.gomez-gonzalez@nisd.net mailto:claudia.gomez-gonzalez@nisd.net mailto:claudia.gomez-gonzalez@nisd.net mailto:bidrequests@nisd.net

II. EVALUATION. Please rate the Proposer utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed.

Attach additional pages if more space is needed.

Evaluation Definitions – The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE (N/A) Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Past Performance Evaluation

1. Has this company provided this type of service to your District/Company? If not, what work did this vendor do for your District/Company?

2. When did this work take place?

3. What was the quality of the vendor’s services and goods to your District/Company?

4. Did the service and goods meet your expectations?

5. Was the work completed in a timely manner?

6. Would you recommend the vendor for future work within your District/company? Why or why not?

7. What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

Exceptional Very Good Satisfactory Marginal Unsatisfactory

General Comments:

File details come from the government source that posted it. Updated .