Exhibit C - 5.10.21 AST edit.docx

EXHIBIT C: PERFORMANCE RELEVANCY QUESTIONNAIRE

Submit for no more than three projects:

Instructions to Offeror:

Provide the following information requested in this format for each of the projects/contracts being described. Projects may be on going and cannot have been completed any later than 5 years prior to the solicitation issue date. Provide concise comments regarding YOUR PERFORMANCE on the contracts you identify.

Offeror (Your) Name (Company/Division):

Project/Contract Title:

Contract Specifics:

Description of Effort as ___Prime or ___Subcontractor Contract Number:

Original Contract $ Value Current/Final Contract $ Value If amounts in 3 above are different, provide a brief description of the reason:

Completion Date:

Original Completion Date:

Estimate/Final Completion Date:

Primary cause for Contract Modifications:

Instructions to Reference Contact:

The contractor named above is submitting a proposal for a United States Department of Veterans Affairs contract and has sent this form to you as a past performance reference contact. Please complete the following pages in full.

Company Name:

POC Name:

Phone Number:

Email:

Street Address:

City/State:

Zip Code:

1. Please provide a narrative of the overall work performed by the requesting offeror, and the scope of their responsibility for the referenced project.

2. Please provide a narrative on how the requesting offeror adhered to the approved project schedule and managed the overall project timeline.

3. Please provide a narrative detailing how the requesting offeror performed in regards to both quality control and overall project safety.

4. Please provide a narrative on how the requesting offeror handled their overall customer relationship for the duration of the project.

Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR / COTR); include a current phone number and email address for each.