36C24718R0307-039.docx

Attachment 3 Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

Offerors submitting past performance information are required to complete and include this cover sheet with their proposal submission.

The entire questionnaire should be forwarded to your previous clients for projects you have provided under evaluation factor 1 – Prime Contractor Experience.

Clients shall directly return the cover sheet and questionnaire to Elissa Goodman at e-mail address: elissa.goodman@va.gov no later than ___(TBD____________

It is the offeror’s responsibility to ensure correct and verifiable point of contact information.

1. Offeror Name (Name of Organization/Firm being Evaluated):

2. Name of Organization/Firm Providing Reference:

3. Address of Organization/Firm Providing Reference:

4. Contract Number:

5. Project Description:

6. Contract/Task Order Amount:

7. Performance Period:

8. Evaluator’s Point of Contact Information:

Name and Title:____________________________________________________________

Phone Number:____________________________________________________________

E-Mail Address:_____________________________________________________________

Attachment 3

SAMPLE TRANSMITALL CORRESPONDENCE SENT FROM CONTRACTOR TO FIRMS COMPLETING PAST PERFORMANCE SURVEYS

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm will be submitting a proposal in response to solicitation VA248-15-R-0863 entitled “Construction Multiple Award Task Order Contract” advertised by Department of Veterans Affairs, Network Contracting Office 8.

In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance; your candid response to the attached questionnaire will assist the evaluation team in this process. Please complete the enclosed questionnaire as thoroughly as possible.

Please note that while the responses to this questionnaire may be released to the offeror, FAR 15.306 (e) (4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please forward your completed questionnaire to the following e-mail address by _(will be completed after review and approval and prior to release of solicitation)____________________________Do NOT return them directly to our company.

elissa.goodman@va.gov

If you have questions regarding the attached questionnaire, or require assistance, please contact Elissa Goodman at e-mail listed above.

Please be advised that “E-Mail” is the only method of receiving the requested information.

Thank you for your assistance.

Solicitation Attachment 3

FOR EVALUATOR COMPLETING QUESTIONNAIRE

Exceptional (E)

Based on the Offeror’s overall past performance, essentially no doubt exists that the Offeror will successfully perform ABOVE AND BEYOND the required effort.

Good (G)

Based on the Offeror’s overall past performance, little doubt exists that the Offeror will successfully perform ALL the required effort.

Satisfactory (S)

Based on the Offeror’s performance record, some doubt exists that the Offeror will successfully perform MOST of the required effort.

Marginal (M)

Based on the Offeror’s overall past performance, substantial doubt exists that the Offeror will successfully perform MOST the required effort. Changes to the Offeror’s existing processes may be necessary in order to achieve contract requirements.

Unsatisfactory (U)

Based on the Offeror’s overall past performance, extreme doubt exists that the Offeror will successfully perform the required effort.

Neutral / Not Applicable or Unknown (N)

No performance record identifiable within the area of evaluation.

SAttachment 3

FOR EVALUATOR COMPLETING QUESTIONNAIRE

EVALUATOR: PLEASE CIRCLE THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E G S M P NR

Attachment 3

FOR EVALUATOR COMPLETING QUESTIONNAIRE

Please explain exceptional, poor, or marginal ratings. Please provide candid responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (attach additional pages if necessary):

Evaluator’s Point of Contact Information:

Signature and Title:________________________________________________________

Phone Number:____________________________________________________________

E-Mail Address:___________________________________________________________