Attachment A - Past Performance Questionaire Rev 1.docx
DOCX document 23 KB Posted
- Attached to
- C223--Replace Air Handling Unit #11 - DESIGN
- Solicitation number
- 36C24625R0017
About this file
This is a Past Performance Questionnaire template associated with solicitation #36C24625R0017 for replacing Air Handling Unit #11 at the Charles George VA Medical Center in Asheville, NC. The template contains rating guidelines and evaluation criteria for references to assess contractors' past performance.
The questionnaire evaluates contractors on a 0-4 scale across four main categories: Quality of Service, Cost Control, Timeliness of Performance, and Business Relations. It includes sections for references to provide detailed feedback on contract compliance, cost management, schedule adherence, and overall satisfaction. The form requests basic contract information including contract number, period of performance, total value, and brief description of services provided. References are asked to indicate if any show cause notices, stop work orders, or contract terminations were issued. The completed questionnaires are to be returned to the VA Contracting Officer Keith Hunter.
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Other files
| File | Type | Posted |
|---|---|---|
| S06 - SF30 36C24625R0017 0001 Cancellation Notification.pdf | ||
| Attachment B- Criterion 2 Format.xlsx | XLSX spreadsheet | |
| 36C24625R0017_1.docx | DOCX document | |
| Attachment A - Past Performance Questionaire.docx | DOCX document |
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Text version
ATTACHMENT B
Past Performance Questionnaire
SOLICITATION NO.:
DESCRIPTION:
Quoters: Please Send to Each Reference Cited in Submitted Quotation
DEPARTMENT OF VETERANS AFFAIRS (VA)
PAST PERFORMANCE QUESTIONNAIRETO: Name of reference, Title of reference E-MAIL: Email address of reference VA SAC is currently in the process of awarding a contract for the solicitation described above. The quoter identified below has provided your organization’s name as a reference under the contract described below:
Quoter Name:
(Insert Quoter’s Name Here)
Contract Number:
(Insert Applicable Contract Number Here)
Please rate the quoter in each of the categories on this questionnaire. See “Rating Guidelines” section for detailed description of categories and ratings. There is room for comments where you deem remarks would be helpful to our evaluation (see ‘Comment from Reference’ under “Quoter Evaluation”. Please note that the past performance evaluators for this solicitation may contact you for further details in making a fair assessment of this quoter’s past performance. Thank you for your organization’s assistance in fairly evaluating quoter’s quotations for this solicitation.
Please E-mail Questionnaire to Keith Hunter, Contracting Officer, at Keith.Humter@va.gov.
| Name of Reference: |
| (Reference Complete These Sections) |
Title of Reference:
Phone Number:
E-Mail Address:
Name of Organization:
Contract Period of Performance (Month/Day/Year Begin and End):
Total Contract Value (Base and All Option Years):
Options Exercised on Contract (Yes/No)?
Brief Description of Services Provided by Quoter:
Show Cause Order Issued on Contract (Yes/No)?
Stop Work Order Issued on Contract (Yes/No)?
Termination for Convenience, Cause, or Default Issued on Contract (Yes/No)?
Rating Guidelines:
| Rating |
| Quality of Service |
| Cost Control |
| Timeliness of Performance |
| Business Relations |
| 0: Unsatisfactory |
| Quoter is not in compliance and has jeopardized achievement of contract objectives |
| Quoter is unable to manage costs effectively |
| Quoter delays have jeopardized performance |
| Responses to inquiries and issues are not effective |
| 1: Poor |
| Major problems have been encountered |
| Quoter has had major difficulty managing costs effectively |
| Quoter has had major difficulty meeting milestones and delivery schedule |
| Responses to inquiries and issues are marginally effective |
| 2: Satisfactory |
| Some problems have been encountered |
| Quoter is having some problems managing costs effectively |
| Quoter is having some problems meeting milestones and delivery schedule |
| Responses to inquiries and issues is somewhat effective |
| 3: Good |
| Minor inefficiencies and errors have been identified |
| Quoter is usually effective in managing costs |
| Quoter is usually effective in meeting milestones and delivery schedule |
| Responses to inquiries and issues is usually effective |
| 4: Excellent |
| Quoter is in compliance with contract requirements and delivers quality services |
| Quoter is effective in managing costs and submits proper invoices |
| Quoter is effective in meeting and exceeding milestones and delivery schedule |
| Responses to inquiries have been effective and/or exceeded expectations and established deadlines |
Quoter Evaluation:
| Rating (List Number Based on Rating Guidelines Above) |
| Category |
| Description |
| Quality of Service |
| In compliance with contract requirements, submits accurate reports/deliverables, has effective personnel, and has achieved/maintained technical excellence: |
Comment from Reference: _______________________
| Cost Control |
| Has achieved efficiencies in costs, managed costs effectively, and has submitted timely/accurate invoices with supporting documentation: |
| Timeliness of Performance |
| Has met milestones, is reliable, is responsive to technical direction, and has completed milestones on-time or ahead of schedule: |
| Business Relations |
| Has maintained effective management of contract, has exhibited reasonable/cooperative behavior, is responsive to contract requirements, is responsive to inquiries/issues, and is proactive about resolving problems: |
|_| YES |_| NO
| Overall Satisfaction |
| Would you (reference) choose to work with this Quoter again? |
CONTRACT/ORDER NUMBER/ TITLE:
PERIOD COVERED:
Place an X in the appropriate response
Performance Standards for Assessment
VERY
| ***BELOW |
| *** |
| EXCELLENT |
| GOOD |
| SATISFACTORY |
| SATISFACTORY |
| POOR |
| VALUE |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
A. MEETING TECHNICAL NEEDS:
1. What level of understanding does the contractor have of my technical needs and my mission requirements?
2. What level of efficiency and effectiveness does the contractor demonstrate in meeting my requirements?
3. Overall, how well does the contractor meet my technical needs and mission requirements?
4. Overall, the quality of the products/services provided are
B. PROJECT MILESTONES AND SCHEDULE:
1. How well does the contractor meet my established milestones and project dates?
2. How timely are products, reports, and invoices completed, reviewed, and delivered?
3. How would you assess the reasonableness of cost of the services being provided and the accuracy of submitted invoice?
4. How well does the contractor notify me in advance about potential milestones and scheduling problems so that I have enough time to correct them?
C. PROJECT STAFFING:
1. How current is the expertise of those contractors performing requested tasks?
2. Do contractor personnel possess the necessary knowledge, skills and ability to accomplish assigned tasks?
3. Are the staffing levels assigned by contractor appropriate for accomplishing the mission?
D. VALUE OF THE CONTRACTOR:
1. How would you assess the value of the services provided by the contractor?
2. How do you rate the quality of the products delivered by the contractor?
3. What overall rating would you give to the contractor's performance?
** Ratings for a Performance Standard are calculated by adding the individual scores under a Performance Standard and dividing it by the number of sub-standards under that Performance Standard.
***Poor and Below Satisfactory ratings must be explained in Section II (Narrative Clarification) below. Must be supportive and objective
II NARRATIVE CLARIFICATION
(USE ADDITIONAL SPACE
AS REQUIRED)
Typed Name And Title of Government Project Lead/ Date
File details come from the government source that posted it. Updated .