36C26118R0541-015.pdf

FOR OFFICIAL USE ONLY – SOURCE SELECTION SENSITIVE WHEN COMPLETED

ATTACHMENT 2 – PAST PERFORMANCE QUESTIONNAIRE

1. GENERAL INFORMATION: (Contractor to be evaluated)

Name of Contractor:

Point of Contact: Title: E-mail:

Address of Record: Office Phone: Fax:

Contract#: Dollar Amount:

Dates of Performance:

Contractor Performed as: Prime Contractor Sub-Contractor Key Personnel

Project Title and Brief Description of Work:

2. RESPONDENT INFORMATION: (Government Official)

Name of Respondent: Title: E-mail:

Address of Record: Office Phone: Fax:

3. TRANSMITTAL INSTRUCTIONS: E-mail completed survey to:

Dario.Rissone@va.gov Dario Rissone, Contract Specialist Completed surveys must be received by the VA directly from the party completing them. Do not forward to the contractor requesting completion of the survey. Due to time constraints, it is important that the questionnaire be completed and returned by the date proposal is due, 20 July 2018 at 4:00 PST.

4. PERFORMANCE INFORMATION: Choose the appropriate adjectival rating that most accurately describes the contractor’s performance.

Exceptional Performance exceeded many contractual requirements to the government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating.

Also, there should have been NO significant weaknesses identified.

Good Performance exceeded some contractual requirements to the government’s benefit. The contractual performance of the element or sub-element being assess was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were effective.

A Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been no significant weaknesses identified.

Satisfactory Performance met contractual requirements. The contractual performance of the element or sub-element being assess was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract.

There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

Marginal Performance did not meet some contractual requirements. The contractual performance of the element or sub-elements being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

A Marginal rating is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner.

Unsatisfactory Performance did not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

Neutral/ Not Applicable or Unknown

No performance record identifiable within the area of evaluation.

Performance was not observed or not applicable to the current effort being reported.

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE. PLEASE PROVIDE NARRATIVE

RESPONSES IF YOU BELIEVE THAT FURTHER EXPLAINATION IS WARRANTED.

1. QUALITY:

Quality of technical data/report preparation efforts E G S M U N

Ability to meet quality standards specified for technical performance

E G S M U N

Timeliness/effectiveness of contract problem resolution without extensive customer guidance E G S M U N

Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

E G S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

Compliance with contract delivery/completion schedules including any significant intermediate milestones E G S M U N

Rate the contractor’s use of available resources to accomplish tasks identified in the contract E G S M U N

3. CUSTOMER SATISFACTION:

To what extent were the end users satisfied with the project? E G S M U N

Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication)

E G S M U N

To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? E G S M U N

Overall customer satisfaction E G S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force? E G S M U N

Ability to hire, apply, and retain a qualified workforce to this effort E G S M U N

Government Property Control E G S M U N

Knowledge/expertise demonstrated by contractor personnel E G S M U N

Utilization of Small Business concerns E G S M U N

Ability to simultaneously manage multiple projects with multiple disciplines E G S M U N

Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes E G S M U N

Effectiveness of overall management (including ability to effectively lead, manage and control the program)

E G S M U N

5. COST/FINANCIAL MANAGEMENT

Ability to meet the terms and conditions within the contractually agreed price(s)?

E G S M U N

Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E G S M U N

If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate backup documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

E G S M U N

Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes

No

6. SAFETY/SECURITY

To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E G S M U N

Contractor complied with all security requirements for the project and personnel security requirements. E G S M U N

7. GENERAL

Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues). E G S M U N

Compliance with contractual terms/provisions (explain if specific issues)

E G S M U N

Would you hire or work with this firm again? (If no, please explain below)

Yes

No

In summary, provide an overall rating for the work performed by this contractor. E G S M U N

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