Atch 3 Past Performance Questionnaire NASH.docx

SUBJECT: Past Performance Questionnaire for 626-22-103 Video Security Surveillance at The TN Valley Healthcare System (TVHS) Nashville Campus, 1310 24th Avenue South, Nashville, TN 37212.

PAST PERFORMANCE INSTRUCTIONS

The NCO 9 Network Contracting Activity has issued a solicitation to upgrade Video Security Surveillance at The TN Valley Healthcare System (TVHS) Nashville Campus, 1310 24th Avenue South, Nashville, TN 37212.

Past performance information will be used to evaluate proposals received. Section A is to be completed by the Offeror. Section A of the enclosed questionnaire lists the contractor who has identified your office as a source to evaluate their past performance. Section A also authorizes release of this information to NCO 9 Network Contracting Activity, Nashville, TN.

Section B in its entirety is to be completed by the assessor(s). An individual assessor knowledgeable of the contractor’s quality of supplies and services rendered is requested to verify, complete the questionnaire, and submit to the Contracting Office. If evaluating more than one contract for the same contractor, use a separate questionnaire for each contract being evaluated.

If Offeror is unable to get Assessor information, please provide a copy of your most recent or final CPARS. In the absence of PPQs, the Government reserves the right to use CPARS as a way to review past performance.

Thank you in advance for your cooperation and expeditious response to this request.

PAST PERFORMANCE QUESTIONNAIRE

SECTION A: Contractor Information (to be completed by the contractor for who past performance information is being collected, prior to forwarding to assessors).

Note: Document is to be forwarded to the Contracting Officer jeannette.morphew@va.gov and contract specialist, jen.jamieson@va.gov

6. Contract Award Date: _________ Contract Amount: Initial ________ Final ___________

7. Period of Performance: _______________________________

ASSESSOR INFORMATION:

Assessor Name

Title

Phone Number/Email Address

8. Authorization is hereby granted to provide the information requested in this questionnaire to NCO 9 Network Contracting Activity, Murfreesboro, Tennessee.

Signature

SECTION B: Assessors Information (to be completed by assessors).

RATING SCALE Definitions

The questions on the survey (see below) shall be rated in accordance with the definitions provided in the Rating Scale. Any unsatisfactory or marginal rating shall be supplemented with an explanation in the space provided.

Management Effectiveness

1. Rate the contractor's compliance with contractual requirements.

a. Offeror provided experienced personnel with technical and administrative abilities to meet contract requirements.

b. Offeror provided appropriate system documentation

c. Offeror’s overall management effectiveness

OUTSTANDING__GOOD__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Quality of Service and Workmanship

2. Rate the contractor's compliance with contractual requirements.

a. Offeror provided professional services

b. Offeror maintained the quality products/services

c. Offeror achieved throughput specifications

d. Offeror achieved accuracy specifications

e. Offeror achieved integration specifications (if applicable)

f. Offeror’s overall quality of products/services

OUTSTANDING__GOOD__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Timeliness/Adherence to Schedules

3. Delivery of service was within required time period specified by contract requirements.

a. Offeror delivered items timely as identified in your contract

b. Offeror was proactive in keeping you informed of schedule conflicts if they were going to occur

c. Offeror responded to emergency requirements in a timely manner

d. Overall offeror timeliness

OUTSTANDING__GOOD__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Training/Technical Support

4. Rate the contractor's ability to provide required training/provide adequate technical support.

a. Offeror provided useful quality training

b. Offeror provided prompt technical support after delivery

c. Offeror’s overall quality of training/technical support

OUTSTANDING__GOOD__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Customer Satisfaction

5. Rate the contractor's ability to satisfy Customer expectations. control cost and submit invoices.

Are invoices complete, accurate, and timely?

a. Offeror maintained a professional working relationship

b. Offeror was reasonable and cooperative in resolving customer complaints

c. Offeror was flexible in responding to urgent requirements

d. Overall customer satisfaction

OUTSTANDING__GOOD__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

How would you feel about awarding another contract to this contractor?

__________ Would not hesitate to award another contract to this contractor.

__________ Would most likely award another contract to this contractor.

__________ Would think twice about awarding another contract to this contractor but would do so if no better alternative existed.

__________ Do not wish to award another contact to this contractor.

__________ Would not award another contract to this contractor.

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Overall rating of contractor's performance (quality, schedule, business relations,) on contract being assessed.

VII. General Comments:

ASSESSOR:

Identify your role in the contract award or administration and the period of your involvement.

Contract Specialist/Contracting Officer

Technical Project Lead/Project Officer

OTHERS

(Phone Number)