36C77020R0001-001.docx

PRE-SOLICITATION ATTACHMENT 1 - PAST PERFORMANCE QUESTIONNAIRE AND COVER LETTER

Complete one set of letters and forms for at least three projects identified in your firm’s Section F of the SF 330, which will best illustrate proposed team’s qualifications for this contract. Additional space or blank sheets may be added to answer any question.

Transmittal letter to accompany Past Performance Questionnaire

[Insert Company Name] is currently responding to the VA National CMOP’s request for SF 330, Architect-Engineer Qualifications for the “CMOP A-E IDIQ”. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance.

[Insert Company Name] is providing past performance data to the VA National CMOP relating to our performance on contract [Insert contract name/number] and have identified [Insert name of reference] as the point of contact for this contract.

The request for SF 330 instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire and submit it by February 24, 2020 & 4PM CST directly to the National CMOP Contracting Office Contracting Officer, Ralph Crum. The requested data may be submitted by mail or email to the government representative identified below. If the Past Performance Questionnaire is emailed, DO NOT send a hard copy via mail.

Ralph Crum Contracting Officer National CMOP Contracting Office (NCO15) 3450 South 4th Street Leavenworth, Kansas 66048 Email: Ralph.Crum@va.gov

The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to [Insert Company Name]. Please direct any questions about the acquisition or the attached questionnaire to the Contracting Officer point of contact identified above.

Thank you, [Insert Company Official Name and Title]

A. GENERAL INFORMATION

A-E FIRM TO BE EVALUATED:

Firm Name: ________________________ Telephone: __________________________ Address: __________________________ Email address: ________________________ __________________________ Point of Contact: ______________________

Firm Cage Code: ____________________ Firm Tax ID Number: ________________ Firm DUNS Number: ________________

Project Title: _____________________________________

Description of Project: __________________________________________________________

Description of A-E Firms’ Responsibilities:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Contract Number: ______________________ Dollar Amount: ______________________

Contract Period of Performance: _______________________

The A-E Firm performed as the Prime Contractor Sub-Contractor/Consultant/Team Member

Percent of work performed by A-E Firm: Other (Please describe) __________________

B. EVALUATOR INFORMATION:

Evaluator’s Company or Agency Name: ____________________________ Evaluator’s Name: _____________________ Address: __________________________ Title of Evaluator: _____________________ __________________________ Telephone: __________________________

C. SEND COMPLETED QUESTIONAIRE (SECTIONS B through D) TO:

Ralph Crum Contracting Officer National CMOP Contracting Office (NCO15) 3450 South 4th Street Leavenworth, Kansas 66048 Email: Ralph.Crum@va.gov

D. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Marginal or Unsatisfactory on page 7 under Narrative Summary.

A-E FIRM’S NAME: _______________ PROJECT NAME: _______________

Contract Period of Performance: _______________________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix on page 4.

Design Services:

Follow-On Construction Support Services:

Overall:

YES

NO

CONTRACTOR’S NAME: ___________________ PROJECT NAME __________

Contract Period of Performance: _______________________ Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

NARRATIVE SUMMARY (Use this section to explain any rating from the previous page)