36C10X19Q0098-002.docx

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Indoor Firing Range Clean Up and Hazardous Waste Removal
Solicitation number
36C10X19Q0098
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36C10X19Q0098 PAST PERFORMANCE QUESTIONNAIRE- Indoor Firing Range Maintenance Services.docx

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ATTACHMENT A

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Request for Quote: 36C10X19Q0098 - Indoor Firing Range Maintenance Services

TO: Allen. L Smith, Contracting Officer AGENCY: VA, SAC-F

PHONE: 240-215-1681 E-MAIL: allen.smith3@va.gov

INFORMATION REQUEST: PAST PERFORMANCE

The Department of Veterans Affairs is currently in the process of awarding a competitive service contract. [CONTRACTOR NAME] has provided this Questionnaire to you for a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT #].

Please send completed questionnaires to [Insert CO and CS Name and Email].

NOTE TO CONTRACTORS: If the Questionnaire is provided for subcontractor’s reference, the contractor’s name below must include both the prime and subcontractor names (e.g. contractor X, subcontractor to contractor Y for this solicitation).

Contractor’s Name:

Name of Person Completing the Evaluation:

Telephone: E-mail:

Title:

Company/Organization:

Please rate the contractor in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.

· Not Applicable: N/A

· 1: Performance clearly below the contract performance standard or requirement

· 2:Performance occasionally does not meet minimum contract performance standard or requirement
· 3:Performance that meets the minimum contract performance standard or requirement
· 4:Performance that meets and occasionally exceeds the contract performance standard or requirement
· 5:Performance that almost always exceeds the contract performance standard or requirement
1. Overall quality/satisfaction
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Overall satisfaction with the Contractor’s performance.

2. Delivery performance
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.

3. Satisfaction with the quality of service delivered
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.

4. Satisfaction with problem resolution
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

This includes the contractor’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.

5. Satisfaction with the quality of contractor personnel
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Rate the quality of the contractor’s staff in executing the project work scope.

6. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years?

|_| Yes |_| No If Yes, please explain.

7. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.

8. Based on the contractor’s overall performance, would you award them another contract?

|_| Yes |_| No If No, please explain.

9. Have you discussed any adverse past performance problems with the Contractor and given them an opportunity to comment? |_| Yes |_| No Please explain.

10. Do you file past performance information in a database that the Contracting Officer may search?|_| Yes |_| No Please explain.

11. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.

12. What was the contract period of performance (i.e., when were services provided)?

13. What was the dollar value of the contract performed by the contractor?

14. Provide a brief description of the services provided by the contractor for this contract.

Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Contractor’s past performance by the evaluator. Please provide information on any adverse performance by the contractor and the corrective actions taken.

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