Exhibit L - Past Performance Questionnaire.pdf
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- Solicitation number
- 36C24W24R0047
- Issued by
-
Department of Veterans Affairs
About this file
This document is a Past Performance Questionnaire for a Department of Veterans Affairs (VA) lease solicitation, RLP #36C24W24R0047, seeking a property lease to facilitate a Behavioral Health Facility in Eugene, OR.
The questionnaire is designed to collect past performance information on prospective lessors/landlords competing for the lease award. It includes instructions for the offeror to complete Section 1, and then forward the questionnaire to 3 references (current or former tenants) to complete Sections 2 and 3. The reference must rate the offeror's performance in areas such as pricing of change orders, ability to stay on schedule and budget during tenant improvements, responsiveness to maintenance, safety, and security issues, and overall lease performance. Failure to submit all past performance questionnaires will result in the offer being deemed non-responsive.
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EXHIBIT L
DEPARTMENT OF VETERAN AFFAIRS
PAST PERFORMANCE QUESTIONNAIRE
Introduction:
This questionnaire is designed to collect past performance information on Offerors (Landlord/
Lessors) competing for award of this lease. Please note this questionnaire is not based on the past performance of brokers facilitating the deal, but rather for the prospective awardees that will be responsible for the lease under consideration.
Instructions to the Offeror:
Please complete Section 1 on the following page. If Offeror checks the “no relevant past performance” box, then do not proceed further in filling out the form, but do submit the form as part of the offering package. If the “no relevant past performance” box IS NOT checked, then Offeror must forward a copy to 3 references, instructing them to complete sections 2 and 3. References must be current or former tenants of the Offeror. Once the respondents complete the remainder of the form, it must be returned to the Offeror and submitted as part of the Offeror’s proposal contents. Failure to submit all past performance questionnaires will be deemed as a non responsive offer.
Attn: Willie Maddox, Lease Contracting Officer
Department of Veterans Affairs, RPOW
Subject: Past Performance Questionnaire RLP #36C24W24R0047
Email: william.maddox@va.gov
For assistance with this questionnaire please contact the Contract Specialist listed above. Hand written responses will be accepted. Responses will be treated as confidential and procurement sensitive.
Past Performance Evaluation:
Acceptable = Based on the offeror's performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror's performance record is unknown
Unacceptable = Based on the offeror's performance record, the Government does not have a reasonable expectation that the offeror will be able to successfully perform the required effort.
Note: If the Offeror is a small business and receives a FAIL rating, the Contracting Officer shall seek a Certificate of Competency from the Small Business Administration. FAR 19.601
PAST PERFORMANCE QUESTIONNAIRE
VA RLP #36C24W24R0047
SECTION 1 – Offeror (Lessor to be evaluated) Information:
Name or Company:
Phone Number:
Email:
Only check this box if the Offeror has no relevant past performance
NOTE: If above statement is checked, do not proceed any further
SECTION 2 ‐ Evaluator Information:
Name: Title:
Phone Number: Email:
Lease Square Footage: Organization/ Company:
Use of Space (Check One): Office Medical Office Other
PAST PERFORMANCE QUESTIONNAIRE
SECTION 3 ‐ Past Performance Questions:
1. During the tenant improvement build out, how was the Lessor’s ability to handle the pricing of change orders?
Acceptable Not Acceptable Please explain:
2. During the tenant improvement build out, how was the Lessor’s ability to stay on schedule?
Acceptable Not Acceptable Please explain:
3. During the tenant improvement build out, how was the Lessor’s ability to stay within budget?
Acceptable Not Acceptable Please explain:
4. In accordance with your lease, the Lessor responds promptly to any maintenance issues.
Acceptable Not Acceptable Please explain:
5. In accordance with your lease, the Lessor responds promptly to any safety issues.
Acceptable Not Acceptable Please explain:
6. In accordance with your lease, the Lessor responds promptly to any security issues.
Acceptable Not Acceptable Please explain:
7. In accordance with your lease, the Lessor adequately keeps the building premises and common areas clean.
Acceptable Not Acceptable Please explain:
8. During your lease term, the Lessor’s overall performance is acceptable.
Acceptable Not Acceptable Please explain:
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