Past Performance Questionnaire Attachment.docx
DOCX document 20 KB Posted
- Solicitation number
- 36C10D26Q0174-1
- Issued by
-
Department of Veterans Affairs
About this file
This is a Past Performance Questionnaire designed to evaluate contractor capability and experience for the Employee Assistance Program (EAP) solicitation issued by the Department of Veterans Affairs under solicitation number 36C10D26Q0174-1.
The questionnaire serves as an evaluation tool to assess offerors' qualifications for providing EAP services to VA employees and their immediate family members, specifically focusing on emotional support and grief counseling capabilities. The document functions as a template for vendors to demonstrate their past performance on similar EAP contracts, mental health service delivery, and employee assistance programs. Respondents are expected to provide documented examples of relevant experience, including contract values, performance periods, client references, and measurable outcomes achieved in previous engagements. The questionnaire likely evaluates factors such as service quality, customer satisfaction, program utilization rates, counselor credentials, and the ability to deliver comprehensive emotional support and grief counseling services. This past performance information will be weighted as part of the overall evaluation criteria to determine which offeror is best qualified to deliver EAP services to the Department of Veterans Affairs workforce.
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| File | Type | Posted |
|---|---|---|
| S02 36C10D26Q0174_1.docx | DOCX document |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Solicitation 36C10D26Q0174
The individual providing the reference shall complete and return NLT 09/09/26 1:00 pm EST to:
Email: Tracey.Robinson3@va.gov
On behalf of (Requester/Contractor Information):
| Company's Name: | __________________ | |
| POC/Title/Position: | __________________ | |
| Email Address: | __________________ | |
| Contract/Purchase Order No.: | __________________ | |
| Contract Amount: | __________________ | |
| Period of Performance: | __________________ | |
| Business Address: | __________________ | |
| __________________ |
Phone Number: __________________
NOTE: DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS REQUEST
The completion of this questionnaire is requested from your agency/company in order for the Department of Veterans Affairs to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract.
Completed by :
| Federal Agency/Company’s Name: | _________________________________ | ||
| POC/Title/Position: | _________________________________ | ||
| Email Address: | _________________________________ | ||
| Address: | _________________________________ | ||
| _________________________________ | |||
| _________________________________ | |||
| Phone Number: | _________________________________ |
1. Quality/Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.
a. How would you describe your level of customer satisfaction?
b. Were there instances of rework and/or deficiency reports? (If yes, explain)
2. Quality/Timeliness.
a. Describe the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?
b. Describe the timeliness of submission of requested information, reports and invoicing.
3. Additional Observations/Information
a. Given hindsight, are you satisfied that the contract was awarded to this contractor? Would you be pleased to have this contractor perform work for you again? Why?
(If more comment space needed, please attach additional pages.)
File details come from the government source that posted it. Updated .