Attachment Y5.3 STO1 - Past Performance Questionnaire_4-18.docx
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- Solicitation number
- 36C10X24R0026
About this file
This document is a Past Performance Questionnaire (PPQ) related to a federal contract opportunity with the Department of Veterans Affairs (VA) for the IHT 2.0 (Integrated Healthcare Transformation 2.0) IDIQ contract. The PPQ requests information from customers regarding a contractor's past performance, including ratings on overall quality/satisfaction, delivery performance, quality of service, problem resolution, and quality of contractor personnel. The customer is asked to indicate if they would award the contractor another contract and provide details on any performance issues or termination actions. The PPQ is to be emailed to VHAIHT2@va.gov with the subject line "IHT STO1 PPQ" by a specified deadline. The related federal contract opportunity is Solicitation Number 36C10X24R0026 for the VHA Integrated Healthcare Transformation 2.0 IDIQ contract, with an anticipated RFP release date of March 14, 2024. The attached draft solicitation and attachments are provided for reference only, and final versions are subject to change.
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Text version
Attachment Y5.3: STO1 PPQ
ATTACHMENT Y5.3: STO1 PPQ
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
RFP 36C10X24R0026 VHA Integrated Healthcare Transformation 2.0
1. Instructions for customer— Please complete sections A, B, and C below and email this questionnaire to: VHAIHT2@va.gov with Subject Line: “IHT STO1 PPQ” no later than _____________.
INFORMATION REQUEST: PAST PERFORMANCE
This office (VA Strategic Acquisition Center) is currently in the process of soliciting and awarding a competitive IDIQ Contract. [PRIME CONTRACTOR NAME] has provided your name and organization as a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT NO.].
Offeror (VITAL) Company Name:
Company Assessed (if different from Offeror above):
Project Title:
2. Customer input--
A. General Information:
Name of Person (Customer) Completing the Evaluation:
| Telephone: | E-mail: | |
| Title: | Company/Organization: |
1. Provide a brief description of the services provided by the offeror for this contract.
2. What was the contract period of performance (i.e., when were services provided)?
3. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.
4. What was the dollar value of the contract performed by the offeror?
B. Performance:
1. Please rate the Company Assessed in each of the following areas. Note: there is room for comments at the end of this form where additional 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 |
a. Overall quality/satisfaction-- Overall satisfaction with the offeror’s performance. Would you (the reference) choose to work with this offeror again?
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
b. Delivery performance-- Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
c. Satisfaction with the quality of service delivered-- Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
d. Satisfaction with problem resolution-- This includes the offeror’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
e. Satisfaction with the quality of contractor personnel-- Rate the quality of the contractor’s staff in executing the project work scope.
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
2. Based on the offeror’s overall performance, would you award them another contract? |_| Yes |_| No If No, please explain.
C. Issues:
1. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem? |_| Yes |_| No If Yes, please explain.
2. Have you terminated this contractor for default, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.
3. Have you discussed any adverse past performance problems with the offeror and given them an opportunity to comment? |_| Yes |_| No Please explain.
D. Other Information
1. Do you file past performance information in a database that the Contracting Officer may search?
|_| Yes |_| No Please explain.
2. Additional comments?
Please attach any past performance database reports or other material you deem appropriate to a full understanding of the offeror’s past performance by the evaluator.
************************************END OF PPQ************************************ Past Performance Questionnaire- IHT 2.0 STO1
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