36C10F20R0017-019.docx
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- Solicitation number
- 36C10F20R0017
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This document contains a past performance questionnaire and information on a related federal contract opportunity for construction services. The past performance questionnaire is a template for evaluating contractors' prior work on similar projects, assessing factors such as quality, schedule, cost control and customer satisfaction. The related federal contract opportunity is a pre-solicitation notice for a design-build-bid construction project to complete Phase 2 of expanding Cape Canaveral National Cemetery in Florida. The project scope involves developing approximately 30 acres for additional burial sites, including over 7,400 full casket gravesites and 12,300 urn crypts. The contract value is estimated between $20-50 million and will be set aside solely for service-disabled veteran-owned small businesses. The Department of Veterans Affairs intends to issue the solicitation in March 2020.
36C10F20R0017 PAST PERFORMANCE QUESTIONNAIRE.docx
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Attachment 3 – Past Performance Questionnaire
PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and mail or send via email to: Elizabeth Monohan (Elizabeth.Monohan@va.gov)
Office of Construction and Facilities Management 425 I Street, NW Washington, DC 20001 Desired Response Date: NLT noon 7/1/2019
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY OFFEROR
1a. CONTRACTOR NAME & ADDRESS:
2. CONTRACT NO.:
3. CONTRACT AWARD DATE:
4. COMPLETION DATE:
5. CONTRACT VALUE (with options): $
1b. NAME OF PRIME CONTRACTOR (If this questionnaire is for a team member)
6. TYPE OF CONTRACT:
7. PROJECT TITLE, LOCATION, AND DESCRIPTION (AND TOTAL CONSTRUCTION VALUE AT PROJECT COMPLETION):
Please add a continuation page if additional space necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.
| E = Exceptional |
| S = Satisfactory |
| U = Unacceptable |
| G = Very Good |
| M = Marginal |
| N/O = Not Observed |
A. Quality of Products and Services - Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).
E G S M U N/O
B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.
E G S M U N/O
C. Schedule – Assess the timeliness of contractor against the schedule of activities.
E G S M U N/O
D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.
E G S M U N/O
E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.
E G S M U N/O
F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.
E G S M U N/O
G. Overall Assessment.
E G S M U N/O
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