36C24718R0165-005.pdf

ATTACHMENT 2: PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE/EXPERIENCE INFORMATION SURVEY

OFFEROR INSTRUCTIONS: A separate record must be completed for each Past

Performance/Experience Information and Survey for FAR 52.212-2; Offeror must directly send a copy of the survey to their selected evaluator for completion and the offeror is responsible for obtaining and submitting the completed survey with their submitted proposal on or before the due date. Survey should be emailed directly to the Contracting Officer (and not to the company being evaluated) at nochelle.elliott@va.gov

Please put “Past Performance Survey for ____________________________(Company Name) for 36C24718R0165 Shuttle” in the subject line of your email.

Name of Offeror being Evaluated:

Address of Offeror:

Solicitation Number: 36C24718R0165 Shuttle Transportation Services at the RHJVAMC

Name of Evaluator:

Position held or function in relation to project:

Company Name:

Address:

Contact Phone Number:

Email Address:

mailto:nochelle.elliott@va.gov

EVALUATOR INSTRUCTIONS:

The evaluator must identify the type of service, dates, location of service, and award value that are being utilized by the evaluator for this past performance/experience survey. This information is needed to determine if the offeror has recent experience providing the same or similar type of service being requested in the subject solicitation.

Type and date(s) of service being evaluated:

Location of service, and award value:

If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“O” = Outstanding = Performance greatly exceeded the contract requirements

“A” = Above Average = Performance exceeded the contract requirements

“S” = Satisfactory = Performance met the contract requirements

“M” = Marginal = Performance met the minimum contract requirements but some material aspects of the contractor’s performance were less than satisfactory

“U” = Unacceptable = Performance was poor and/or did not satisfy contract requirements

Please rate and provide information/comments for the following:

Circle One

Q1. To what extent did the company comply with overall contract requirements?

O A S M U

Q2. How did the company comply with the regularly scheduled pick-up and delivery times for shuttle transportation services?

O A S M U

Q3. How well did the company comply with labor and safety standards?

O A S M U

Q4. How well did the company react to changes that affected the scheduled pick-up drop-off times and locations?

O A S M U

Q5. How well did the company perform in ensuring all passengers who were at the pickup points at the appointed time adequate transportation?

O A S M U

Q6. Rate the effectiveness of the company’s management of the contract and their employees?

O A S M U

Q7. Rate the overall quality of the services provided by the company?

O A S M U

Q8. How well did the company notify you of potential issues that would impact the timely pick-up and delivery of passengers?

O A S M U

Q9. How well did the company maintain their vehicles (maintenance issues, climate control, and cleanliness)?

O A S M U

Q10. OVERALL RATING OF THE

COMPANY PERFORMANCE

O A S M U

Q11. Have any cure notices, show cause letters, suspension of payment, or termination of contract notices been issued? If yes, please explain.

Circle One

Yes No

Q12. Would you recommend this company provide courier services to your organization in the future? If no, please explain.

Circle One

Yes No

Additional Remarks:

Evaluator Printed Name/Signature

Date