36C24920R0031-004.docx
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- Solicitation number
- 36C24920R0031
About this file
This document is a combined synopsis/solicitation for psychiatry services on weekends and holidays at the Robley Rex VA Medical Center in Louisville, Kentucky. The Department of Veterans Affairs is seeking proposals for a base year starting April 1, 2020 through March 31, 2021 plus four optional one-year extensions to provide .4 FTE of weekend and holiday psychiatry services. The contractor must provide psychiatrists licensed and in good standing to meet all requirements in the performance work statement. Proposals are due by January 28, 2020 and will be evaluated on technical approach, past performance, and price. The contract will be a small business set-aside awarded on a firm-fixed price basis to the offeror representing the best value.
36C24920R0031 Attachment 4-Past Performance Survey.docx
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24920R0031-001.docx | DOCX document | |
| 36C24920R0031-003.docx | DOCX document | |
| 36C24920R0031-000.docx | DOCX document | |
| 36C24920R0031-002.docx | DOCX document |
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36C24920R0031 - ATTACHMENT 4 PAST PERFORMANCE SURVEY
PSYCHIATRIST SERVICES – WEEKENDS AND HOLIDAYS
REFERENCE INSTRUCTIONS: The Department of Veterans Affairs is seeking offerors for award of a VA contract for psychiatrist services on weekends and holidays for a base year plus four option years. You have been identified as a reference and your comments would be appreciated. Your comments are considered Source Selection Sensitive; therefore, you are advised that the release of the names of individuals providing reference information about Offeror’s past performance is prohibited. Survey should be completed by evaluator and submitted no later than January 28, 2020 @ 3:00 p.m. CT via email directly to alyson.allman@va.gov.
NOTE: Incomplete or unsigned surveys will not be considered.
Company being evaluated:_______________________________________________ Period of Performance:__ What was the average monthly volume of the services provided? (Number of psychiatrists provided? Average number of hours worked per month?) ______________________________________ Name and title/position of evaluator:
Contact telephone number:
Contact e-mail address:
Please evaluate the past performance using only the following ratings without variation. If the rating is other than Fully Acceptable, please provide additional information in the appropriate block or in the remarks section of this form.
S = Superior Performance
V = Very Good with very few issues
F = Fully Acceptable/Good
M = Marginally Acceptable
U = Unacceptable Performance
| Please rate and provide information/comments for the following: |
| Circle/indicate selection |
| Q1. Rate how well the contractor complies with requirements and/or expectations? |
| S V F M U |
| Q2. Rate contractor’s knowledge and expertise in providing psychiatrist services. |
| S V F M U |
| Q3. Rate this contractor’s physicians. |
| S V F M U |
| Q4. Rate the level of access to the contractor’s personnel. (i.e. Did they respond in a timely manner? Did they meet the requirements of being available and responding as according to the contract?) |
| S V F M U |
| Q5. Rate overall ease of contractor’s scheduling process. |
| S V F M U |
| Q6. Rate how well contractor protects the privacy of patients. |
| S V F M U |
Q9. Would you award another contract to the firm being evaluated? If no, please explain:
Yes No
Additional Remarks: Please use this space to indicate anything else you would like to say about the contractor being referenced or to list anything you especially liked or disliked about this contractor:
| Signature of Evaluator |
| Date |
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