Past Performance Survey.docx
DOCX document 14 KB Posted
- Solicitation number
- 36C26126Q0978
About this file
This is a Past Performance Survey template designed for evaluating contractor qualifications in response to VA solicitation 36C26126Q0978 for Telephone Operator/Switchboard Services at VA Palo Alto Health Care System. The survey serves as a standardized assessment tool that offerors must complete for each reference and submit with their quotes, while also functioning as an evaluation instrument for the Department of Veterans Affairs to gather feedback from previous clients regarding a company's performance capabilities.
The survey requests evaluators to provide specific information about past contract performance, including the company name, evaluator contact information, contract details (total contract amount, performance dates, and contract number), and ratings across key performance dimensions. Evaluators are asked to rate overall quality of work on a five-point scale (Excellent, Good, Fair, Marginal, Unacceptable) with supporting comments, and to identify any performance issues or concerns encountered and how those issues were resolved. The template emphasizes that evaluator identities remain confidential and will not be released publicly, protecting the reference sources while allowing VA to make informed award decisions based on demonstrated past performance in delivering similar services.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 36C26126Q0978 0002.pdf | ||
| CSQ Agent Summary Report .xlsx | XLSX spreadsheet | |
| CSQ Agent Summary Report - 1.xlsx | XLSX spreadsheet | |
| Amendment 36C26126Q0978 0001.pdf | ||
| Attachment 2 - Quality Assurance Surveillance Plan.pdf | ||
| P07 WD 2015-5641.pdf | ||
| S02 36C26126Q0978 Palo Alto.pdf |
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Text version
OFFEROR INSTRUCTIONS: A separate worksheet must be completed for each reference. The completed surveys must be included with the quote.
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.
Name of Company being evaluated:
Evaluator’s Name:
Evaluator’s Company Name, Address and Phone number:
Indicate what contracts 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?
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