Amend 2 Attachment C - Past Performance Questionnaire.docx
DOCX document 27 KB Posted
- Attached to
- Y1DA--Upgrade IT Systems Infrastructure (VA-22-00040622) Federal contract opportunity
- Solicitation number
- 36C24622R0025
About this file
This document contains a past performance questionnaire for evaluation of contractors responding to a federal solicitation for upgrade of IT systems infrastructure at the Hampton VA Medical Center. The solicitation seeks all labor, materials, tools, equipment, engineering, and services for installation of new underground duct banks, outdoor cabinets, fiber optic and electrical cabling, and related professional services with a magnitude between $2 million to $3 million. Responses are due approximately 38 days after issuance of the solicitation on or about March 1, 2022. The opportunity is anticipated as a Service-Disabled Veteran Owned Small Business set-aside, and prospective contractors must be registered in SAM and ORCA to be eligible for award. References are requested to complete Section B and C of the attached past performance questionnaire regarding quality, timeliness, management effectiveness, safety compliance, and overall performance for evaluation of contractor past projects.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| S02 - 36C24622R0025 0002.docx | DOCX document | |
| 36C24622R0025 0001.docx | DOCX document | |
| Upgrade IT Systems Infrastructure - Revised Specifications.pdf | ||
| S02 - 36C24622R0025_1.docx | DOCX document | |
| Attachment B - Corp Experience Form.docx | DOCX document | |
| Attachment A - Base Proposal Item Price Breakdown.xlsx | XLSX spreadsheet | |
| Construction Safety Handbook.pdf | ||
| Drawings Upgrade IT Systems Infrastructure.pdf | ||
| 36C24622R0025.docx | DOCX document |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
EXHIBIT A : PAST PERFORMANCE QUESTIONAIRRE REQUEST LETTER
FROM:
[Insert Company Official Name, Title, and Company Name]
SUBJECT: Request for Past/Present Performance Information
[Insert Company Name] is currently responding to VHA Network Contracting Office 6 and Hampton VA Medical Center, regarding a request for proposal for Project 590-19-115, Upgrade IT Systems Infrastructure. This Request for proposal requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance.
[Insert Company Name] is providing past performance data to VHA Network Contracting Office 6 relating to our performance on contract [Insert contract name/number] and have identified [Insert name of reference] as the point of contact for this contract.
The request for proposal instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire (Sections B and C) and return it by no later than 5:00PM EST, May 23, 2022. Return the completed questionnaire directly to the Government Contracting Officer, Keith Norman, via email at keith.norman2@va.gov.
*Do not return this form to the Contractor requesting the reference. *
Past Performance Questionnaire
SECTION A.1: Contractor and Project Information (to be completed by the contractor (offeror) prior to sending to references.
A. Contractor’s name and address: _________________________________________
B. Project Owner -POC: _________________________________________
| C. Phone: | _________________________________________ | |
| D. Email Address: | _________________________________________ |
D. Contract Number: _________________________________________ E. Project Title/Desc of Work: _________________________________________
| _________________________________________ | ||
| F. Contract Type: | _________________________________________ | |
| G. Project Award Date: ______________ | Scheduled Completion Date: ________________ |
Current/Final Completion Date: ________________
H. Project Award Amount: ____________ Current/Final Project Amount: ________________
I. Contractor being evaluated performed as the: Prime Contractor Subcontractor Supplier
A.2: EVALUATED BY: (to be completed by Project Owner)
(Signature) (Date)
_____________________________________ Address: _____________________________ (Typed or Printed Name) _____________________________________ (Title)
(Phone/Fax/Email)
| A |
| B |
| C |
| D |
NA
| Substantial Confidence |
| Satisfactory Confidence |
| Limited Confidence |
| No |
Confidence
Unknown Confidence
| Based on the offeror’s performance record, there is a high expectation that the offeror will successfully perform. |
| Based on the offeror’s performance record, there is an expectation that the offeror will successfully perform. |
| Based on the offeror’s performance record, there is low expectation that the offeror will successfully perform. |
| Based on the offeror’s performance record, there is no expectation that the offeror will successfully perform. |
No performance record is identifiable, or the offeror’s performance record is so sparse that no rating can be reasonably assigned.
EVALUATION AREAS
I. Quality A B C D NA
| 1. |
| Contractor provided effective quality control and inspection procedures that resulted in a quality-finished project. |
| □ |
| □ |
| □ |
| □ |
| 2. |
| Contractor developed and submitted realistic progress schedules. |
| □ |
| □ |
| □ |
| □ |
| 3. |
| Contractor provided well researched and clearly identified submittals that matched contract requirements. |
| □ |
| □ |
| □ |
| □ |
| 4. |
| Contractor completed all work with good workmanship and in conformance with the specifications, resulting in minor, if any, punchlist items. |
| □ |
| □ |
| □ |
| □ |
| 5. |
| Contractor thoroughly reviewed drawings and specifications for accuracy, completeness, and compliance with contract requirements. |
| □ |
| □ |
| □ |
| □ |
II. Timely Performance A B C D NA
| 1. |
| Contractor met established project schedules to complete the project on time. |
| □ |
| □ |
| □ |
| □ |
| 2. |
| Contractor performed all work without the issuance of a cure notice or show cause letter. (If a notice was issued, please describe the circumstances on a separate sheet of paper and identify if liquidated damages were assessed.) |
| □ |
| □ |
| □ |
| □ |
| 3. |
| Contractor provided timely cost/design proposals. |
| □ |
| □ |
| □ |
| □ |
| 4. |
| Contractor submitted the progress schedule and interim progress reports as required in a timely manner and the schedule was approved prior to actual construction. |
| □ |
| □ |
| □ |
| □ |
| 5. |
| Contractor provided submittals on time as required. |
| □ |
| □ |
| □ |
| □ |
| 6. |
| Contractor provided payrolls for both their firm and their subcontractor’s employees as required and scheduled |
| □ |
| □ |
| □ |
| □ |
| 7. |
| Contractor provided timely resolution of all punchlist items. |
| □ |
| □ |
| □ |
| □ |
III. Management Effectiveness A B C D NA
| 1. |
| Contractor provided experienced qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
| □ |
| □ |
| □ |
| □ |
| 2. |
| Contractor hired quality subcontractors and effectively managed and coordinated their work. |
| □ |
| □ |
| □ |
| □ |
| 3. |
| Contractor hired, maintained, and replaces as necessary, qualified personnel and subcontractors/suppliers. |
| □ |
| □ |
| □ |
| □ |
| 4. |
| Contractor ensured the site manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule. |
| □ |
| □ |
| □ |
| □ |
| 5. |
| Contractor provided timely and satisfactory response to warranty issues after project completion. |
| □ |
| □ |
| □ |
| □ |
| 6. |
| Contractor paid employees/subcontractors/suppliers as required. |
| □ |
| □ |
| □ |
| □ |
| 7. |
| Contractor cooperated to resolve problems, attended meetings and maintained communication to assure satisfactory resolution. |
| □ |
| □ |
| □ |
| □ |
IV. Compliance with Safety Standards A B C D NA
| 1. |
| Adequacy of Safety Plan |
| □ |
| □ |
| □ |
| □ |
| 2. |
| Implementation of Safety Plan |
| □ |
| □ |
| □ |
| □ |
V. Overall Performance A B C D NA
| 1. |
| Please rate the contractor’s overall performance |
| □ |
| □ |
| □ |
| □ |
Additional Information:
(1) Identify the contractor's overall strengths and weaknesses.
(2) Given the choice, would you award to this contractor again?
(3) Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.
(4) Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.
(If more comment space is needed, please attach pages.)
Thank you for taking the time to complete this questionnaire.
File details come from the government source that posted it. Updated .