Past Performance Survey.docx

DOCX document 16 KB Posted

Attached to
H266--Pharmaceutical Compounding Room/Hood Testing - VANCHCS Federal contract opportunity
Solicitation number
36C26124Q0390
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21

About this file

This document is a Past Performance Survey for a federal contract opportunity with the U.S. Department of Veterans Affairs (VA). The survey is intended to gather feedback from the offeror's previous customers regarding the quality of work performed and any performance issues. The survey asks the evaluator to provide information on the services the company provided, the contract amount, dates of performance, and contract number. The evaluator is then asked to rate the overall quality of work on a scale from Excellent to Unacceptable and provide comments on any performance issues or concerns. This survey is being requested as part of the evaluation process for Solicitation Number 36C26124Q0390 for "H266--Pharmaceutical Compounding Room/Hood Testing - VANCHCS" issued by the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 21.

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Text version

Past Performance Survey 36C26123P0390

OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be submitted directly to durell.salaz@va.gov.

EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the company listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. The name of the individuals providing reference information is confidential and will not be released or made publicly available.

Please Note: When completing this Survey be sure to summarize what service(s) you provided on the contract(s) to include the performance dates, dollar amount(s) and contract number(s).

Name of Company being evaluated:

Evaluator’s Name and signature:

Evaluator’s Company Name, Address and Phone number:

Indicate what services did this company provided for you? Provide the total contract amount, dates of performance, and contract number.

Evaluation Questions

Please rate the overall quality of work using a scale of (Excellent, Good, Fair, Marginal, Unacceptable). Comments in support of the rating are welcome.

Were there any performance issues/concerns? If so, how were they handled?

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