36C24721Q0001 0002_1.docx

Contract Opportunity Amendment to a Previous Combined Solicitation

PRODUCT SERVICE CODE

SUBJECT

CONTRACTING OFFICE'S

ZIP-CODE

SOLICITATION NUMBER

BASE NOTICE TYPE

RESPONSE DATE/TIME/ZONE

ARCHIVE

DAYS AFTER THE RESPONSE DATE

RECOVERY ACT FUNDS

SET-ASIDE

NAICS CODE

CONTRACTING OFFICE

ADDRESS

POINT OF CONTACT

(POC Information Automatically Filled from User Profile Unless Entered)

DESCRIPTION

See Attachment

AGENCY'S URL

URL DESCRIPTION

AGENCY CONTACT'S EMAIL

ADDRESS

EMAIL DESCRIPTION

ADDRESS

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

GENERAL INFORMATION

PLACE OF PERFORMANCE

* = Required Field Contract Opportunity Amendment to a Previous Combined Solicitation J046

RFQ - DE-IONIZATION - TANKS ONLY

30084 36C24721Q0001 09-03-2020 12pm

EASTERN TIME, NEW YORK, USA

N 221330 Department of Veterans Affairs VISN 7 Network Contracting Office LaVista Business Park - Bldg A 2008 Weems Road Tucker GA 30084 Darlene.Chase@va.gov

Past Performance Survey

OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be included with the offeror’s technical proposal.

EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the Offeror listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. Your comments are considered Source Selection Sensitive. The name of the individuals providing reference information is confidential and will not be released or made publicly available.

Name of Company being evaluated:

Evaluator’s Name:

Evaluator’s Company Name, Address and Phone number:

Indicate what contracts did this offeror provided for your company? Provide the total contract amount, dates of performance, and contract number.

Evaluation Questions

Comment on the overall quality of contractor’s work.

Were there any performance issues/concerns? If so, how were they handled?

If any changes were needed, was the contractor flexible in responding to those changes?