36C24219R0172-003.docx

ATTACHMENT 1 - PAST PERFORMANCE QUESTIONNAIRE

Please send this questionnaire to at least three (3) projects identified in your firm’s SF 330 Section F, Example Projects which best illustrate proposed team’s qualifications for this work. Additional space or blank sheets may be added to answer any question. IF PAST PERFORMANCE ACASS/CPARS IS NOT AVAILABLE, THEN OFFEROR TO SEND THIS QUESTIONNAIRE TO MINIMUM OF 3 PRIOR CLIENTS AS LISTED IN SF330. OFFEROR TO PLACE THEIR NAME IN RESPECTIVE BLANK SPACES BELOW, AS INDICATED “AE NAME” “AE FIRM TO BE EVALUATED.”

Transmittal Letter to Accompany Past Performance Questionnaire

A. GENERAL INFORMATION

FROM: _________________________________

SUBJECT: Past Performance Questionnaire for Contract(s):

AE Name____________________________________ is currently responding to VA Medical Center Northport request for SF 330, Architect-Engineer Qualifications for the “Repair Steam and Condensate Lines, Project #561A4-18-106,” at Veterans Affairs Medical Center, Lyons NY. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding ____________________AE Name________________ performance.

Recommender Name___________________________________ is providing past performance data to Lyons VA Medical Center relating to our performance on contracts and have identified Recommender Contact______________________________________ as the points of contact for these contracts.

The request for SF 330 instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire and submit it by email, regular mail or delivery service by August 14, 2019 11:59 PM ET, directly to the VA Contracting Officer, Joseph Ercole, at:

Joseph Ercole Contracting Officer U.S. Department of Veterans Affairs 79 Middleville Rd., Bldg. 10, Section 138, Rm. 216 Northport, NY 11768 joseph.ercole@va.gov

The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to AE Name____________________. Please direct any questions about the acquisition or the attached questionnaire to Joseph Ercole, Contracting Officer, at point of contact identified above.

A. GENERAL INFORMATION (CONTD’)

A-E FIRM TO BE EVALUATED:

Firm Name: _________________________ Telephone: _________________________ Address: _________________________ Email: ____________________________ Point of Contact: _____________________ Firm Cage Code: _____ Firm Tax ID Number: ________ Firm DUNS Number: ________

Description of A-E Firms’ Responsibilities:

Contract Number: ______________________ Dollar Amount: ______________________

Contract Period of Performance: ___

The A-E Firm performed as the ☐ Prime Contractor Sub-Contractor/Consultant/Team Member

Percent of work performed by A-E Firm: __% Other (Please describe)

EVALUATOR INFORMATION:

Evaluator’s Company or Agency Name: ________________________ Evaluator’s Name: ________________ Address: ________________________ Title of Evaluator: ________________ ________________________ Telephone: ____________________ E-mail: ______________________

1. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Exceptional and Marginal-Unsatisfactory on page 7 under Narrative Summary.

See below-

A-E FIRM’S NAME: ______________________ PROJECT NAME: ____________

Contract Period of Performance: ___

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

C. Using the Performance Information Descriptions in ‘B’ above, place an “X” in the appropriate columns using the definitions matrix in ‘B’ above.

Item

FACTORS TO BE RATED

Design Services:

Follow-On Construction Support Services:

LEED (If Applicable):

BIM (If Applicable):

Owner’s Representative on Design/Build Projects (If Applicable):

Overall:

NO

Number of A/E Design Errors & Omissions on Project: _______________

Increased Project Cost Due to A/E Design Errors & Omissions: _______________

A-E FIRM’S NAME: ______________________ PROJECT NAME: ____________

Contract Period of Performance: ___

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

D. NARRATIVE SUMMARY (Use this section to explain any rating from the previous pages, especially 5 Exceptional and 1 Unsatisfactory and N/A-Not Applicable)

Add more rows as needed

SEND COMPLETED QUESTIONAIRE TO:

Joseph Ercole, Contracting Officer, NCO2 U.S. Department of Veterans Affairs 79 Middleville Rd. Section 138, Bldg. 10, Rm. 216 Northport, NY 11768 OR BY EMAIL: joseph.ercole@va.gov This information is per:

VA Policies and Regulations, Information Letter 001AL-10-03 at:

http://www1.va.gov/oamm/docs/library/ils/il10-03.pdf

VA Policies and Regulations, Information Letter 90-01-2 at: http://www1.va.gov/oamm/oa/ars/policyreg/ils/il01_2.cfm

FAR 12.206 states that a contractor's past performance should be an important element of every evaluation and contract award for commercial items;

FAR 42.1501 states that past contractor performance information should include, among other relevant information, the contractor's adherence to contract schedules.

Acquisition Reform Network website, http://www.ARNet.gov; website, the Office of Procurement Policy (OFPP) has posted a best practices guide entitled, "Best Practices for Collecting and Using Current and Past Performance Information."

The revised guidance leaves this matter at the discretion of the agencies. Acquisition professionals should note that, FAR Subpart 15.305(a)(2)(iv) states that the lack of a past performance history may not be evaluated favorably or unfavorably.

FAR Part 36 applies to architect and engineering services.

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