36C25625Q0632 - Attachment D.1 - Past Performance Questionnaire.pdf
PDF 334 KB Posted
- Attached to
- Chartered Flight Services Federal contract opportunity
- Solicitation number
- 36C25625Q0632
About this file
This document is a Past Performance Questionnaire for the Michael E. Debakey VA Medical Center, associated with solicitation number 36C25625Q0632 for Chartered Flight Services. The form is designed for references to evaluate a potential contractor's past performance across multiple dimensions, including overall quality, delivery performance, service quality, problem resolution, and personnel quality. References are asked to rate performance on a scale from 1-5, with 5 representing performance that almost always exceeds contract standards, and provide additional context through optional comments and specific questions about the contractor's history.
The questionnaire requires references to address critical aspects such as whether cure notices or termination actions have been issued, willingness to award another contract, and opportunities to discuss performance issues. The form is to be completed by April 04, 2025 (2:00 pm CST) and submitted via email to Kolbi.barton@va.gov. The purpose is to gather comprehensive feedback to support the VA's source selection process for a contract involving chartered flight services to transport organs from outside the Organ Procurement Organization's primary service area.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25625Q0632 - Attachment D.3 - Historical Data.pdf | ||
| Combined Synopsis Solicitation RFQ 36C25625Q0632 - Flight Services MEDVAMC.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
36C25625Q0632 Attachment D.1
PAST PERFORMANCE QUESTIONNAIRE
REFERENCE INSTRUCTIONS: The Michael E. Debakey VA Medical Center is considering the Offeror listed below for award of a VA contract. Your comments would be appreciated regarding this firm’s past performance.
The intent of this form is to evaluate the offeror’s services. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition Regulation prohibits the release of the names of individuals providing reference information about Offeror’s past performance. This survey should be completed by an evaluator with sufficient familiarity of the offeror’s performance and returned to the contracting office by the evaluator no later than April 04, 2025 (2:00 pm, CST) the closing date of the solicitation by e-mail to Kolbi.barton@va.gov.
Include the solicitation number on the subject line of all e-mails. Solicitation Number: 36C25625Q0632
Offeror’s Name: Offeror’s e-mail:
Request for Quotation:
Name of Person Completing the Evaluation:
Telephone: E-mail:
Title:
Company/Organization:
Please rate the offeror in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.
• Not Applicable: N/A
• 1: Performance clearly below the contract performance standard or requirement
• 2: Performance occasionally does not meet minimum contract performance standard or requirement
• 3: Performance that meets the minimum contract performance standard or requirement
• 4: Performance that meets and occasionally exceeds the contract performance standard or requirement
• 5: Performance that almost always exceeds the contract performance standard or requirement
1. Overall quality/satisfaction N/A 1 2 3 4 5
Overall satisfaction with the Offeror’s performance. Would you (the reference) choose to work with this offeror again?
2. Delivery performance N/A 1 2 3 4 5
Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.
3. Satisfaction with the quality of service N/A 1 2 3 4 5 mailto:stephanie.keo@va.gov mailto:schon.zwakman@va.gov.
36C25619Q0890 Attachment D.1 delivered
Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.
4. Satisfaction with problem resolution N/A 1 2 3 4 5
This includes the offeror’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.
5. Satisfaction with the quality of contractor personnel N/A 1 2 3 4 5
Rate the quality of the contractor’s staff in executing the project work scope.
6. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years?
Yes No If Yes, please explain.
7. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions?
Yes No If Yes, please explain.
8. Based on the offeror’s overall performance, would you award them another contract?
Yes No If No, please explain.
9. Have you discussed any adverse past performance problems with the Offeror and given them an opportunity to comment?
Yes No Please explain.
10. Do you file past performance information in a database that the Contracting Officer may search?
Yes No Please explain.
11. If the contract had options, were those options exercised?
Yes No Please explain.
12. List the dates of the contract period of performance (when were services provided)?
13. What was the dollar value of the contract performed by the offeror?
14. Provide a brief description of the services provided by the offeror for this contract.
36C25619Q0890 Attachment D.1
Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Offeror’s past performance by the evaluator.
File details come from the government source that posted it. Updated .