ATTACHMENT F - PAST PERFORMANCE QUESTIONAIRE_Revised.docx

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Attached to
J056--Correct Fire (Life) Safety Issues (Construction)
Solicitation number
36C24626R0078
Issued by

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This is a Past Performance Questionnaire template that offerors must complete as part of their proposal submission for the Department of Veterans Affairs contract to correct fire and life safety issues through construction.

Offerors are required to provide a minimum of three (3) and a maximum of five (5) examples of completed projects or in-progress contracts demonstrating similar size and scope, with each contract having a minimum value exceeding $1,000,000. Contracts must be listed in chronological order beginning with the most recent. For each contract example, offerors must provide comprehensive information including the customer/company name and address, point of contact information (name, title, email, and phone number), contract value, contract term dates, contract effective date, current status (ongoing or completed), and a detailed description of the scope of work performed. This questionnaire serves as documentation of the offeror's corporate experience and technical capability to perform work similar to the solicitation requirements for fire and life safety construction projects at Veterans Affairs facilities.

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ATTACHMENT F - PAST PERFORMANCE QUESTIONNAIRE

Please list your contracts in chronological order beginning with the most recent one. Offerors must provide a minimum of three (3) and a maximum of five (5) examples of their choice of completed projects or in progress of similar contracts in size and scope with a minimum threshold value exceeding $1,000,000. See Technical Capability Sub-Factor 2 – Corporate Experience for all required information to be included.

Contract #1

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status ___Ongoing ___Completed

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #2

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #3

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #4

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #5

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

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