PPQ -Request form.docx
DOCX document 597 KB Posted
- Solicitation number
- 36C24827Q0004
About this file
This is a Past Performance Questionnaire template designed for reference contacts to evaluate contractor performance on federal contracts, specifically for the Department of Veterans Affairs.
The form instructs contractors to provide the questionnaire to past performance references, who must complete and return it directly to the Contracting Officer, David Hernandez, at david.hernandez1@va.gov. References evaluate contractor performance using a six-point rating scale based on FAR 42.1503 Table 42-1: Unsatisfactory (1), Marginal (2), Satisfactory (3), Very Good (4), Exceptional (5), and Not Applicable (6). Each rating level includes specific definitions addressing whether performance met contractual requirements and the effectiveness of corrective actions. The Satisfactory rating indicates performance meets requirements with minor problems resolved effectively, while Exceptional performance exceeds contractual requirements significantly with few minor issues. The form requires the reference contact to provide printed name, title, and signature along with remarks supporting their ratings. This template is applicable to the Bay Pines VAMC steam piping repair project (Solicitation 36C24827Q0004), a set-aside contract for Service-Disabled Veteran-Owned Small Businesses (SDVOSB).
View the file
Other files
| File | Type | Posted |
|---|---|---|
| PPQ.pdf | ||
| SHOP DRAWINGS HIGH PRESSURE STEAM PUMPED ROVANCO PIPING SYSTEM.pdf | ||
| Base Offer Price Breakdown - 1 page.xlsx | XLSX spreadsheet | |
| 516-26-117 Specifications 00 01 10.pdf | ||
| 05_SOW 516-26-117.pdf | ||
| 05_Drawings SECTION LP302- 516-26-117.pdf | ||
| EMR 1 page.docx | DOCX document | |
| WD-FL20260222 DATED 5-18-26.pdf | ||
| 36C24827Q0004_1.pdf | ||
| PPQ.pdf | ||
| Base Offer Price Breakdown - 1 page.xlsx | XLSX spreadsheet | |
| 05_ASBUILTS-516-26-117.pdf | ||
| SHOP DRAWINGS HIGH PRESSURE STEAM PUMPED ROVANCO PIPING SYSTEM.pdf | ||
| WD-FL20260222 DATED 5-18-26.pdf | ||
| 05_Drawings SECTION LP302- 516-26-117.pdf | ||
| 36C24827Q0004_1.pdf | ||
| 516-26-117 Specifications 00 01 10.pdf | ||
| EMR 1 page.docx | DOCX document | |
| ASBUILTS-516-26-117.pdf | ||
| SHOP DRAWINGS HIGH PRESSURE STEAM PUMPED CONDENSATE ROVANCO PIPING SYSTEM.pdf | ||
| 05_Drawings LP302- 516-26-117.pdf | ||
| 36C24827Q0004.docx | DOCX document |
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Text version
PAST PERFORMANCE QUESTIONNAIRE – SOLICITATION #
INSTRUCTIONS TO CONTRACTOR: Complete the CONTRACTOR INFORMATION section below and send to the point of contact listed requesting they please complete the form and submit it according to the instructions below.
INSTRUCTIONS TO REFERENCE CONTACT: The contractor named above is submitting an offer to a prime contractor for a United States Department of Veterans Affairs contract requirement, and has sent this form to you, in your role as a past performance reference contact. Please complete this form in full. Once completed, please send the form to the Contracting Officer only by email:
Department of Veterans Affairs NCO 8 Contracting Office TO: David Hernandez Contracting Officer, Email: david.hernandez1@va.gov
REF SOLICITATION NUMBER:
Reference FAR 42.1503 Table 42-1
1 - Rating: Unsatisfactory Definition: Performance does not meet most contractual requirements, and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the Contractor's corrective actions appear or were ineffective.
2 - Rating: Marginal Definition: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated 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.
3 - Rating: Satisfactory Definition: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the Contractor appear, or were, satisfactory.
4 - Rating: Very Good Definition: Performance meets contractual requirements and exceeds some to the Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.
5 - Rating: Exceptional Definition: Performance meets contractual requirements and exceeds many to the Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.
6 - N/A (not applicable) should be used if the ratings are not going to be applied to a particular area for evaluation.
Remarks:
Printed Name and Title
Signature image3.png image4.png image1.png image2.png
File details come from the government source that posted it. Updated .