Ex K Past Performance Questionnaire_12.11.25.pdf

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Attached to
Request for Lease Proposal - Laughlin Community-Based Outpatient Clinic
Solicitation number
36C24W25R0107
Issued by

About this file

This document is a Past Performance Questionnaire for a Veterans Affairs (VA) Real Estate Lease Proposal (RLP) numbered 36C24W25R0107. The form is designed to collect performance feedback from previous tenants about potential lessors/landlords. The questionnaire includes eight detailed evaluation areas covering tenant improvement build-out, maintenance, safety, security, building cleanliness, and overall performance, with rating options ranging from "Good" to "Unsatisfactory".

The form is to be completed by the offeror (potential lessor) in Section 1, then forwarded to current or former tenants who will complete Sections 2 and 3, providing detailed performance ratings and commentary. The completed questionnaire will be submitted as part of the proposal contents to the Lease Contracting Officer, John Paul Niega, at the Department of Veterans Affairs. The purpose is to assess a lessor's historical performance across multiple dimensions to help evaluate their suitability for the lease opportunity.

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Text version

VA RLP # 36C24W25R0107

Exhibit K - 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 any further in filling out the form and submit the form as part of the offering package. Otherwise, Offeror must forward a copy to current or former tenants of the Offeror instructing them to complete sections 2 and 3 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.

Attn: John Paul Niega, Lease Contracting Officer Department of Veteran Affairs, RPOW Subject: Past Performance Questionnaire RLP # 36C24W25R0107 Email: johnpaul.niega@va.gov Office: 775.389.6616

For assistance with this questionnaire please contact the Contract Specialist listed above. Handwritten responses will be accepted. Responses will be treated as confidential and procurement sensitive.

Explanation of Codes:

GOOD – Lessor met and often exceeded expectations ACCEPTABLE – Lessor met but rarely exceeded expectations NEUTRAL – Lessor simply met expectations MARGINAL – Lessor did not fully meet expectations UNSATSIFACTORY – Lessor failed to meet expectations NOT APPLICABLE – Unable to provide a score mailto:johnpaul.niega@va.gov

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

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?

Good Acceptable Neutral Marginal Unsatisfactory Not applicable

What could have improved your score:

2.During the tenant improvement build out, how was the Lessor’s ability to stay on schedule?

3.During the tenant improvement build out, how was the Lessor’s ability to stay within budget?

4.In accordance with your lease, how has the Lessor responded to any maintenance issues?

5.In accordance with your lease, how has the Lessor responded to any safety issues?

6.In accordance with your lease, how has the Lessor responded to any security issues?

7.In accordance with your lease, how was the Lessor’s ability to keep the building premises and common areas clean?

8.During your lease term, how was the Lessor’s overall performance?

File details come from the government source that posted it. Updated .