36C24218Q0300-002.docx

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ADHC Medical-VSN
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36C24218Q0300
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36C24218Q0300 PAST PERFORMANCE EVALUATION.docx

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PAST PERFORMANCE EVALUATION

The Past performance evaluation factors will be rated as acceptable, unacceptable or neutral. Past performance will be evaluated on quality of service, recent and relevant contracts, and other references.

DeterminationDefinition
AcceptableThe offeror meets or exceeds the (acceptability) standard.
UnacceptableThe offeror fails to meet the (acceptability) standard.
NeutralThe offeror had no past performance to submit with their offer.

Proposals that lack any past performance will receive a neutral rating. Past performance shall consist of:

1. Is the contractor an incumbent VA-contracted facility?

Yes

No Contract Number

Acceptable Unacceptable

Neutral

2. Review of the nursing home’s most recent State inspection report including any Statement of Deficiencies and Plan of Correction

Acceptable Unacceptable

Neutral

COMMENTS:

THE VENDOR’S OVERALL PAST PERFORMANCE IS RATED AS:

Acceptable Unacceptable Neutral

Evaluator Signature: Date:

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