36C10X24R0052 ATTACHMENT D - PAST PERFORMANCE QUESTIONNAIRE (PPQ).pdf

RFP 36C10X24R0052 ATTACHMENT D - Past Performance Questionnaire (PPQ)

REQUEST FOR QUOTE # 36C10X24R0052

Title: Career Path Consulting Services

Agency: Department of Veterans Affairs (VA) – Veterans Health Administration (VHA)

The VA is currently in the process of soliciting a competitive service contract. The Contractor listed below has provided this Questionnaire to you for a reference regarding their record of past performance under the contract or other award number listed below;

Contract/Award # Contract Date(s) Dollar Value

Note to Offerors: if the questionnaire is provided for a subcontractor’s reference, the Contrctor’s name below must include both the subcontractor’s name and the Offeror’s name who will be the prime contractor for this solicitation (e.g. Contractor X, who will be a subcontractor to Offeror Y for this solicitation.)

Contractor’s Name:________________________________________________________________

Contract Title/Number: ________________________________________________________________

Name of Person Completing the Evaluation: _______________________________________________________________

Telephone: ___________________________Email: ___________________________

Title:_________________________________________________________________

Company/Organization:_______________________________________________________________________

Description of Work:

Instructions: Please rate each of the following areas based on the scale provided below.

Performance Areas Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

1. QUALITY

Assess the achieved service performance relative to performance parameters required by the contract or order.

Comments:

2. SCHEDULE

Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

3. COST CONTROL (Not required for Fixed Price type contracts or orders)

Assess the Contractor’s effectiveness in forecasting, managing, and controlling contract or order cost.

4. MANAGEMENT

Assess the integration and coordination of all activity needed to execute the contract or order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

5. UTILIZATION OF SMALL BUSINESS

Assess compliance with all terms and conditions in the contract or order relating to Small Business participation (including FAR 52.219-8 Utilization of Small Businesses, and FAR 52.219-9 Small Business Subcontracting Plan, when required).

6. REGULATORY COMPLIANCE

E.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension, and debarments. Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes, using the Evaluation Ratings Definitions.

7. Other Area -

8. Other Area -

9. Other Area -

10. Overall Recommendation Would Would Not

Given what I know today about the contractor’s ability to execute what he promised in his proposal, I _________________ award to him today given that I had a choice.

Please provide this form completed to the Contracting Officer for this requirement no later than _01 JUL 2024 BY 1PM EASTERN TIME via email to

Michael.Collins7@va.gov. You may copy the Offeror simultaneously.

mailto:Michael.Collins7@va.gov