36C25019Q0935-002.docx

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NIHCS Turfgrass Hydroseeding Federal contract opportunity
Solicitation number
36C25019Q0935
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 10

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36C25019Q0935 Past Performance Questionnaire.docx

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EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE

Please complete this questionnaire in regard to the contractor or contract identified below:

CONTRACTOR:___________________________________________
___________________________________________
___________________________________________

RE: SOLICITATION NO.

NATURE OF WORK:

RETURN TO: David Boyd, Contract Specialist, david.boyd7@va.gov Telephone: 317-988-1559

For the following questions, choose the number on the scale from 1 to 5, which most accurately describes the Contractor’s performance on the contract listed above. A “5” represents superior performance while a “1” represents unacceptable performance. If the question is not applicable, circle “N/A”. Please add any comments and information that may help to determine the Contractor’s probable performance.

1. Was the contractor’s work performed in a skillful and good 1 2 3 4 5 N/A workmanship like manner?

2.Did the contractor conform to the terms andconditions1 2 3 4 5 N/A
of the contract?

3. Was the contractor reasonable and cooperative during 1 2 3 4 5 N/A and after contract performance?

4 Did the contractor submit paperwork timely and completely? 1 2 3 4 5 N/A

5.Did the contractor coordinate and keep control of the1 2 3 4 5 N/A
subcontractors?
6.Did the contractor comply with laws, regulations, and1 2 3 4 5 N/A
facility rules?
7.Evaluate the Contractor’s overall quality of work under1 2 3 4 5 N/A
the contract.
8.Would you award similar contracts to the Contractor1 2 3 4 5 N/A
in the future?

Past Performance Questionnaire

COMMENTS:

Thank you for your assistance.

NAME:

COMPANY/AGENCY:

ADDRESS:

PHONE:

SIGNATURE:

TITLE: _______

DATE:

PLEASE RETURN TO: David Boyd at David.boyd7@va.gov

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