36C24818R0331-003.pdf

Design Build to Provide an Equivalent Level of Life Safety Code Compliance at Main Building Hospital Corridors at VA Caribbean Healthcare System, San Juan, PR Solicitation 36C24818R0331

Attachment 2 - Past Performance Survey

Provide a minimum of two (2) or up to a maximum of three (3) of the most relevant and recent contracts, in similar scope or magnitude to this project.

1. Contractor Name, Address, phone number, email address and DUNS number:

COMPANY NAME:____________________________

COMPANY POC:________________________________

ADDRESS:______________________________

E-MAIL:__________________________________________

DUNS:_______________________________

2. Project Title: ____________________________________.

3. Client/Agency: ____________________________________.

4. Contract Number: ____________________________________.

5. Contract Amount: ____________________________________.

6. Period of Perfomance: Award date:______________Completion Date:_______________

7. Contracting Officer or Person overall responsible:

Name: ____________________________________.

Phone Number: ____________________________________.

Email: ____________________________________.

8. COR or Inspector/Quality Control:

Name: ____________________________________.

Phone Number: ____________________________________.

Email: ____________________________________.

9. Brief Description of Project:

Attachment 3 - Past Performance Questionnaire

TO BE COMPLETED BY REFERENCED CLIENT:

Ensure, when return this completed Questionnaire, do it in pdf format attention to Rey F. Clemente, Contracting Officer via e-mail at Rey.Clemente@va.gov NLT 7 calendar days prior to RFP closing date. Note: When sending back to Contracting Officer by email – ensure the following: Ensure Email Subject line is as follows: Past Performance, Company Name, RFP #.

Contract Number: ___________________________________________________ Title: _____________________________________________________________ Contract Amount: ___________________________________________________ Contractor: ________________________________________________________

PAST PERFORMANCE QUESTIONNAIRE

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

E (EXCELLENT) – Performance meets contractual requirements and exceeds the Government’s expectations. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. (HIGH

CONFIDENCE)

G (GOOD) – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. (SIGNIFICANT CONFIDENCE)

S (SATISFACTORY) – Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective action taken by the contractor appear or were satisfactory. (CONFIDENCE)

M (MARGINAL) –Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented. (LITTLE CONFIDENCE)

P (POOR) – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective. (NO CONFIDENCE)

N (NEUTRAL) – No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative nor positive assessment.)

Attachment 3 - Past Performance Questionnaire (continued)

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. Was this a competitive Contract? YES NO

2. Role of contractor. Prime Sub

3. Ability to meet quality standards specified for technical performance.

E G S N

M P

4. Compliance with contractual terms and conditions. E G S N

M P

5. Quality/integrity of technical data/report preparation efforts.

E G S N

M P

6. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements.

E G S N

M P

7. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program).

E G S N

M P

8. Effectiveness of on-site management, including management of subcontractors?

E G S N

M P

9. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports).

E G S N

M P

10. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

E G S N

M P

11. Ability to successfully respond to emergency and/or surge situations.

E G S N

M P

12. Effectiveness of on-site management and control multidiscipline construction categories, including subcontractors.

E G S N

M P

13. Effectiveness of material management. E G S N

M P

14. Effectiveness of acquisition management. E G S N

M P

15. Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

E G S N

M P

16. Contractor safety record. E G S N

M P

17. Responsiveness regarding safety issues. E G S N

M P

18. If this is/was a Government cost type contract, the Contractor’s timeliness in submitting monthly invoices with appropriate back-up documentation and monthly status reports/budget variance reports.

E G S N

M P

19. If this is/was a Government cost type contract, the Contractor’s accuracy regarding monthly invoices with appropriate back-up documentation and monthly status reports/budget variance reports.

E G S N M P

20. Ability to hire/apply a qualified workforce to this effort. E G S

N M P

21. Ability to retain a qualified workforce on this effort. E G S

N M P

22. If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Indicate if show cause or cure notices were issued, or any default action in comment section below.

E G S N M P

23. Have there been any indications that the contractor has had any financial problem? E G S

N M P

24. In summary, provide an overall rating for the work performed by this contractor. E G S

N M P

COMMENTS: Objective Comments/ concerns relating to this Offeror.

REFERENCED CLIENT: Ensure, when return this completed Questionnaire, do it in pdf format attention to Rey F. Clemente, Contracting Officer via e-mail at Rey.Clemente@va.gov NLT 7 calendar days prior to RFP closing date.