Past Performance Questionnaire.docx

This is a Past Performance Questionnaire template designed for evaluating contractor performance on federal contracts with the Department of Veterans Affairs. The form is used to collect reference information from past clients regarding a company's work quality and performance history. Evaluators are instructed to complete a separate questionnaire for each reference, with responses sent to jill.williams@va.gov. The template requests the evaluator's name, signature, company information, and specific details about contracts previously performed by the company being evaluated, including total contract amounts, performance dates, and contract numbers.

The questionnaire includes an evaluation section that asks references to rate the overall quality of work on a five-point scale (Excellent, Good, Fair, Marginal, Unacceptable) with space for supporting comments. References are also asked to identify any performance issues or concerns that occurred during contract performance and describe how such issues were resolved. This questionnaire is being used as part of the evaluation process for Solicitation 36C26127Q0025, a Fire Alarm and Protection System Inspection and Preventive Maintenance contract set aside 100% for Service-Disabled Veteran-Owned Small Business (SDVOSB) concerns with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21, with quote submissions due by 11:00 AM PST on September 25, 2026.