36C10G18Q9147-006.docx
DOCX document 17 KB Posted
- Attached to
- NX EQ Oxygen Concentrators Federal contract opportunity
- Solicitation number
- 36C10G18Q9147
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36C10G18Q9147 ATTACHMENT F - PAST PERFROMANCE QUESTIONAIRE.docx
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C10G18Q9147-004.docx | DOCX document | |
| 36C10G18Q9147-003.docx | DOCX document | |
| 36C10G18Q9147-002.docx | DOCX document | |
| 36C10G18Q9147-001.xlsx | XLSX spreadsheet | |
| 36C10G18Q9147-000.docx | DOCX document | |
| 36C10G18Q9147-005.xlsx | XLSX spreadsheet |
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Text version
Past Performance Questionnaire
SOLICITATION NO.: 36C10G-18-Q-9147
DESCRIPTION: Non-Expendable Equipment Dermatomes
DEPARTMENT OF VETERANS AFFAIRS (VA)
STRATEGIC ACQUISITION CENTER (SAC)
PAST PERFORMANCE QUESTIONNAIRE
TO: Name of reference, Title of reference E-MAIL: Email address of reference VA SAC is currently in the process of awarding a requirements contract for the solicitation described above. The quoter identified below has provided your organization’s name as a reference under the contract described below:
Quoter Name:
(Insert Quoter’s Name Here)
Contract Number:
(Insert Applicable Contract Number Here)
Please rate the quoter in each of the categories on this questionnaire. See “Rating Guidelines” section for detailed description of categories and ratings. There is room for comments where you deem remarks would be helpful to our evaluation (see ‘Comment from Reference’ under “Quoter Evaluation”. Please note that the past performance evaluators for this solicitation may contact you for further details in making a fair assessment of this quoter’s past performance. Thank you for your organization’s assistance in fairly evaluating quoter’s quotations for this solicitation.
Please E-mail Questionnaire to Michael Schrantz at michael.schrantz@va.gov By (4:00 pm EST SEPTEMBER 20, 2018)
| Name of Reference: |
| (Reference Complete These Sections) |
Title of Reference:
Phone Number:
E-Mail Address:
Name of Organization:
Contract Period of Performance (Month/Day/Year Begin and End):
Total Contract Value (Base and All Option Years):
Options Exercised on Contract (Yes/No)?
Brief Description of Services/Commodities Provided by Quoter:
Show Cause Order Issued on Contract (Yes/No)?
Stop Work Order Issued on Contract (Yes/No)?
Termination for Convenience, Cause, or Default Issued on Contract (Yes/No)?
Rating Guidelines:
| Rating |
| Quality of Service |
| Cost Control |
| Timeliness of Performance |
| Business Relations |
| 0: Unsatisfactory |
| Quoter is not in compliance and has jeopardized achievement of contract objectives |
| Quoter is unable to manage costs effectively |
| Quoter delays have jeopardized performance |
| Responses to inquiries and issues are not effective |
| 1: Poor |
| Major problems have been encountered |
| Quoter has had major difficulty managing costs effectively |
| Quoter has had major difficulty meeting milestones and delivery schedule |
| Responses to inquiries and issues are marginally effective |
| 2: Satisfactory |
| Some problems have been encountered |
| Quoter is having some problems managing costs effectively |
| Quoter is having some problems meeting milestones and delivery schedule |
| Responses to inquiries and issues is somewhat effective |
| 3: Good |
| Minor inefficiencies and errors have been identified |
| Quoter is usually effective in managing costs |
| Quoter is usually effective in meeting milestones and delivery schedule |
| Responses to inquiries and issues is usually effective |
| 4: Excellent |
| Quoter is in compliance with contract requirements and delivers quality services |
| Quoter is effective in managing costs and submits proper invoices |
| Quoter is effective in meeting and exceeding milestones and delivery schedule |
| Responses to inquiries have been effective and/or exceeded expectations and established deadlines |
Quoter Evaluation:
| Rating (List Number Based on Rating Guidelines Above) |
| Category |
| Description |
| Quality of Service |
| In compliance with contract requirements, submits accurate reports/deliverables, has effective personnel, and has achieved/maintained technical excellence: |
Comment from Reference: _______________________
| Cost Control |
| Has achieved efficiencies in costs, managed costs effectively, and has submitted timely/accurate invoices with supporting documentation: |
| Timeliness of Performance |
| Has met milestones, is reliable, is responsive to technical direction, and has completed milestones on-time or ahead of schedule: |
| Business Relations |
| Has maintained effective management of contract, has exhibited reasonable/cooperative behavior, is responsive to contract requirements, is responsive to inquiries/issues, and is proactive about resolving problems: |
| |_| YES |_| NO |
| Overall Satisfaction |
| Would you (reference) choose to work with this Quoter again? |
CONTRACTOR:
GOVERNMENT REQUIRING ACTIVITY:
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