36C26319Q0469-006.doc

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36C26319Q0469 Water Testing- Legionella VAMC Saint Cloud, MN Federal contract opportunity
Solicitation number
36C26319Q0469
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23

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36C26319Q0469 Legionella Water Sample collection and testing Past Performance doc.doc

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PAST PERFORMANCE INFORMATION

Instructions:

Complete the following past performance information for the three (3) most recent contracts, within the last five (5) years, your firm has had for Legionella Water Sample collection and Testing Services for contracts. Identify all Federal, State, and local government contracts and private contracts of similar scope, size, and complexity that are ongoing, or have been completed within the last five (5) years, or in the alternative to “contracts”, indicate nature of past performance in the regular conduct of business. Provide a list of three (3) references pertaining to those contracts including name, address, contact person, and telephone number. Include Information that depicts contract compliance, financial stability and efficiency, and customer satisfaction.

Company or Agency Name: ________________________________________________

Point of Contact: _________________________________________________________

Phone Number: __________________________________________________________

Contract Number: _________________________________________________________

Contract Period: __________________________________________________________

Approx. Dollar Value of contract: _____________________________________________

PERFORMANCE LEVELS

RATING

DEFINITION

E
Exceptional / High Confidence. Based on the offeror’s performance record, essentially no doubt exists that the offeror will successfully perform the required effort.
VG
Very Good / Significant Confidence. Based on the offeror’s performance record, little doubt exists that the offeror will successfully perform the required effort.
S
Satisfactory / Confidence. Based on the offeror’s performance record, some doubt exists that the offeror will successfully perform the required effort.
M
Marginal / Little Confidence. Based on the offeror’s performance record, substantial doubt exists that the offeror will successfully perform the required effort. Changes to the offeror’s existing processes may be necessary in order to achieve contract requirements.
U
Unsatisfactory / No Confidence. Based on the offeror’s performance record, extreme doubt exists that the offeror will successfully perform the required effort.
N/UC
Neutral / Unknown Confidence. No performance record identifiable, not part of contract performance

I. Technical Capacity A. Rate the contractor’s compliance/ adherence to applicable regulations for legionella testing.

RATING_________

Comments:_________________________________________________________________________________________________________________________________________ B. Were reports and or documents required by the contract provided or available for on-site review?

RATING_________

Comments:_________________________________________________________________________________________________________________________________________

C.

Contractors capacity to meet the requirements of the contract. Contractor’s ability to identify and correct potential weakness in managerial capacity (e.g. resources, planning/scheduling, emergency plan, etc.)

RATING_________

Comments:_________________________________________________________________________________________________________________________________________ II. Performance-administrative functions A. Does the contractor submit timely, accurate invoices.

RATING_________

Comments:___________________________________________________________________________________________________________________________________________ B. Rate the working relationship between your organization and the contractor. Would you have any reservations about soliciting this contractor in the future?

RATING_________

Comments:___________________________________________________________________________________________________________________________________________ C. Rate the responsiveness of the contractor to meeting delivery schedules, customer inquiries and or complaints, and problem resolution.

RATING_________

Comments:____________________________________________________________________________________________________________________________________________

D. Rate the contractor personnel on professionalism, courtesy, and overall performance.

RATING_________

Comments:____________________________________________________________________________________________________________________________________________

You may provide additional comments regarding contract compliance, financial stability and efficiency, customer satisfaction, problems encountered and corrective actions taken.

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