36C78618Q0406-001.docx

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Tree Pruning - Long Island National Cemetery PROJECT 815-M&R18-03
Solicitation number
36C78618Q0406
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36C78618Q0406 Past Performance Questionnaire.docx

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Past Performance Questionnaire, Solicitation: 36C78618Q0406 – Attachment A

INSTRUCTIONS: -Offeror to complete boxes 1 through 7 before sending to past customer.

-Boxes 8 through 10 to be completed by past customer of Offeror and returned to: iris.chen1@va.gov no later than the date provided by the solicitation. NOTE: It is incumbent upon the offeror to have the customer send the completed questionnaire to email address above by the submission deadline.

1. Contractor Name and Address:
2. Contract No.
3. Contract Type:
4. Contract Value (Current plus any unexercised Options)
7. Period of Performance
1b. Point of Contact & Contact Information
5. Customer Name:
FROM:
6. Customer Point of Contact Information (email)
TO:

8. DESCRIPTION OF REQUIREMENT:

9. RATINGS - Summarize contractor performance and check the box corresponding to the performance rating for each category. See page 2 for rating descriptions.

(a)

QUALITY

1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

COMMENTS

(b)

SCHEDULE

1 [ ] 2 [ ] 3 [ ] 4 [ ]

COMMENTS

(c)

COST/PRICE

CONTROL

1 [ ] 2 [ ] 3 [ ] 4 [ ]

COMMENTS

(d) Management 1 [ ] 2 [ ] 3 [ ] 4 [ ]

COMMENTS

(e) Regulatory Compliance 1 [ ] 2 [ ] 3 [ ] 4 [ ]

COMMENTS

10. OVERALL RATING:

NAME AND SIGNATURE OF EVALUATOR

EVALUATION DATE

RATING GUIDELINES

Rating
Definition
5. Exceptional
Performance meets contractual requirements and exceeds many to the Government's benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
4. Very Good
Performance meets contractual requirements and exceeds some to the Government's benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
3. Satisfactory
Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
2. Marginal
Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.
1. Unsatisfactory
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor's corrective actions appear or were ineffective.

(End of Section)

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