PPQ - EHRM Baltimore VAMC.docx
DOCX document 104 KB Posted
- Solicitation number
- 36C77623R0010
About this file
This pre-solicitation notice seeks SF 330 statements of qualifications from architecture and engineering firms for design services related to infrastructure upgrades at the Baltimore VA Medical Center to support implementation of a new electronic health record system. Firms must submit SF 330s by January 6, 2023 to be considered for this two-phase selection process, which will initially evaluate SF 330s and then invite the top three firms to submit written responses for final evaluation and selection. The design project has a 365-day period of performance from notice of award and includes site investigations, schematic design, design development, construction documents, cost estimates, specifications and construction period services to upgrade fiber, network cabling, electrical and HVAC distribution to support approximately 100 additional IT outlets and 75 new electrical outlets. The project has a budget between $10-25 million and is set aside 100% for service-disabled veteran-owned small businesses.
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Other files
| File | Type | Posted |
|---|---|---|
| Request for SF 330s Baltimore VAMC.docx | DOCX document | |
| 36C77623R0010_3.docx | DOCX document | |
| 36C77623R0010_2.docx | DOCX document | |
| SOW EHRM Infrastructure Upgrades - Baltimore MD.pdf | ||
| SOW Attachment 01 - VHA Required Div 01 Spec Sections.pdf | ||
| SOW Attachment 02 - VA OEHRM Site Infrastructure Requirements 2-0.pdf | ||
| Attachment 2E- CLC Phase4 Specs Volume 2.pdf | ||
| SOW- Construct CLC Basement Addition.doc | DOC document | |
| PPQ - Basement Philadelphia VAMC.docx | DOCX document | |
| 36C77623R0010.docx | DOCX document | |
| Attachment 2D- CLC Phase4 Specs Volume I.pdf |
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Text version
VA PROGRAM CONTRACTING ACTIVITY CENTRAL ● 6100 OAK TREE BLVD SUITE 490 ● INDEPENDENCE, OH 44131
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
*All PPQs are included in the page count for SF 330 submissions.
SECTION 1
CONTRACT INFORMATION – Contractor to complete #1-3
1. CONTRACTOR INFORMATION
NAME OF OFFEROR BEING EVALUATED: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
POINT OF CONTACT: Click or tap here to enter text.
CONTACT PHONE NUMBER: Click or tap here to enter text.
CONTACT EMAIL ADDRESS: Click or tap here to enter text.
WORK PERFOMED AS: Click or tap here to enter text.
PERCENT OF PROJECT WORK PERFORMED: Click or tap here to enter text.
IF SUBCONTRACTOR, WHO WAS THE PRIME? Click or tap here to enter text.
2. CONTRACT INFORMATION
CONTRACT TITLE: Click or tap here to enter text.
CONTRACT NUMBER AND DO/TO NUMBER: Click or tap here to enter text.
CONTRACT TYPE: Choose an item.
if other:
CONTRACT LOCATION: Click or tap here to enter text.
AWARD DATE: Click or tap to enter a date.
ORIGINAL CONTRACT ACCCEPTANCE (construction accepted) Date: Click or tap to enter a date.
ACTUAL CONTRACT ACCEPTANCE: Click or tap to enter a date.
EXPLAIN DIFFERENCES: Click or tap here to enter text.
ORIGINAL IMPLEMENTATION PRICE: Click or tap here to enter text.
ORIGINAL CONTRACT PRICE (all costs - design/installation/financing): Click or tap here to enter text.
FINAL CONTRACT PRICE (including modifications, if applicable): Click or tap here to enter text.
EXPLAIN DIFFERENCES: Click or tap here to enter text.
3. PROJECT DESCRIPTION
SCOPE INCLUDED IN PROJECT: Click or tap here to enter text.
HOW IS THIS PROJECT RELEVANT TO PROJECT OF SUBMISSION? Click or tap here to enter text.
SECTION 2
EVALUATOR INFORMATION – Client to complete
Veterans Health Administration (VHA) Program Contracting Activity Central (PCAC) is considering the Offeror identified above for award of the Electronic Health Record Modernization Infrastructure Upgrades Design Project at the Baltimore VAMC in Baltimore, MD.
Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate the company’s ability to perform the work as described in the solicitation. Please verify the accuracy of the information in Section 1 and complete the questionnaire as thoroughly as possible. VHA-PCAC may contact you in order to obtain any additional information regarding a contract award.
Please return your completed questionnaire to the Offeror to be incorporated into the SF 330 submission. PPQs should not be submitted directly to VHA PCAC by the client. Refer to the solicitation for SF 330 submission due date.
EVALUATOR INFORMATION
NAME OF EVALUATOR: Click or tap here to enter text.
POSITION: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
PHONE: Click or tap here to enter text.
EMAIL: Click or tap here to enter text.
DESCRIBE YOUR ROLE IN THE PROJECT: Click or tap here to enter text.
*Please see Page 4 for Adjectival Ratings for the following:
1. QUALITY
| Ability to meet quality design and/or construction standards specified for technical performance |
| Choose an item. |
| Comments: |
2. SCHEDULE/ TIMELINESS OF PERFORMANCE
| Compliance with contract delivery/completion schedules including timely submission of data deliverables (If liquidated damages were assessed or the schedule was not met, please address below.) |
| Choose an item. |
| Comments: |
3. COMMUNICATION
| Contractor was reasonable and cooperative in dealing with client staff (including the ability to successfully resolve disagreements/disputes and responsiveness to client requests) |
| Choose an item. |
| Comments: |
4. MANAGEMENT/ PERSONNEL/ LABOR
| Effectiveness of management, including suppliers, materials, and/or labor force (including the ability to effectively lead, manage, and control the project) |
| Choose an item. |
| Continuity in the contractor’s personnel during execution of the contract (e.g., one person or team that stayed with the project throughout the contract) |
| Choose an item. |
| Comments: |
5. COST/ FINANCIAL MANGEMENT
| Ability to meet the terms and conditions within the contractually agreed price |
| Choose an item. |
| Comments: |
6. SUBCONTRACT MANAGEMENT
Ability to manage subcontracting effort, including any subcontracting issues, and the contractor’s ability to resolve the problems without extensive customer guidance
Choose an item.
Comments:
7. SUMMARY
| Would you hire or work with this firm again? If no, please explain below. |
| Choose an item. |
| Provide an overall rating for the work performed by this contractor. |
| Choose an item. |
ADDITIONAL COMMENTS:
| EVALUATOR SIGNATURE: |
| DATE: |
ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
*THIS PAGE WILL BE REMOVED FOR EVALUATION PURPOSES AND NOT BE COUNTED TOWARD THE SF 330 PAGE COUNT – IT IS FOR PPQ COMPLETION PURPOSES ONLY*
| Rating |
| Definition |
| Outstanding |
| The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective. |
| Above Average |
| The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Offeror were effective. |
| Satisfactory |
| The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Offeror were satisfactory. |
| Unsatisfactory |
| Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the Offeror has yet to identify corrective actions or the Offeror’s proposed actions appear only marginally effective or were not fully implemented. |
| Not Applicable |
| No information or did not apply to your contract. |
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