4- Past Performance Questionnaire 36C248-22-Q-0162.pdf
PDF 131 KB Posted
- Attached to
- 6835--HOME OXYGEN Federal contract opportunity
- Solicitation number
- 36C24822Q0162
About this file
This document includes a past performance questionnaire and solicitation for home oxygen services. The Department of Veterans Affairs, West Palm Beach VA Healthcare System is seeking quotes for a base contract and four option years to provide home oxygen to veterans. Quotes are due no later than November 30th, 2022 and should be emailed to Malcolm.Davis@va.gov with the subject line RFQ# 36C24822Q0162. This is a tiered solicitation that will first consider quotes from SDVOSBs, then VOSBs, small businesses, and finally large businesses if necessary. The NAICS code is 532283 for home medical equipment rental with a size standard of $35 million. Interested parties must be registered in both VetBiz.gov and SAM.gov to be considered. The past performance questionnaire requests ratings on previous technical performance, schedule, cost control, business relations, management, and an overall rating. It also asks if the reference would do business with the offeror again.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1- SF30 Amendment 36C24822Q0162 0003.pdf | ||
| 2- SF30 Amendment 36C24822Q0162 0002 Signed.pdf | ||
| 1- Solicitation-Description Amendment 0002.pdf | ||
| 3- Solicitation 36C24822Q0162 Amendment 0002.pdf | ||
| SF 30 Amendent 36C24822Q0162 0001 Signed.pdf | ||
| Solicitation 36C24822Q0162.pdf | ||
| 2- Performance Work Statement 36C248-22-Q-0162.pdf | ||
| 5- Evalualtion Criteria 36C248-21-Q-0162.pdf | ||
| 36C24822Q0162.docx | DOCX document | |
| 1- Combined Synopsis Solicitation 36C248-22-Q-0162.pdf | ||
| 3- Price Schedule 36C248-22-Q-0162.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Name of offeror: ___________________________________
Contract Information:
Name of Contractor: _________________________________ Contract Number: ___________________________
Contract Title: ________________________________________________________________________________
Type of Contract: ____________________________________ Period of Performance: ______________________
The ratings indicated below are to be supplied by the reference and not the offeror)
Performance Elements Satisfactory Unsatisfactory
1. Technical (Quality of Product or Service) (evaluation of the contractor’s technical performance or progress toward meeting requirements)
2. Schedule (evaluation of the timeliness of the contractor against milestones, delivery schedules)
3. Cost Control (evaluation of the contractor’s effectiveness in forecasting, managing, controlling cost and submitting accurate invoices)
4. Business Relations (assess the integration and coordination of all activity needed to execute the work, specifically the timeliness, completeness and quality of problem identification, corrective action, the contractor’s history of reasonable and cooperative behavior, customer satisfaction)
5. Management of Key Personnel (assess the contractor’s personnel performing the work)
6. Overall Rating
Remarks on unsatisfactory performance (Provide data supporting this observation. You may continue on separate sheet if needed.)
Would you do business with the offeror again? ________________________________________________________
Information provided by:
Name of Source: ___________________________________________________ Title: ____________________________________________________________ Mailing Address: ___________________________________________________ City, State and Zip Code: ____________________________________________ Telephone Number: ________________________________________________ Date: ____________________________________________________________
Questionnaire completed by:
Name of VA Employee: ____________________________________________ Title: ___________________________________________________________ Date: ___________________________________________________________ Signature: _______________________________________________________
File details come from the government source that posted it. Updated .