Attach 2- Past Performance Survey.docx

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S201--HILO CBOC HOUSKEEPING SVC (VA-21-00063699)
Solicitation number
36C26121Q1197
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Attachment 2 Past Performance Survey

OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be email to maria.teodoro-tanksley@va.gov on or before the due date of the solicitation.

EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the company listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. The name of the individuals providing reference information is confidential and will not be released or made publicly available.

Name of Company being evaluated:

Evaluator’s Name:

Evaluator’s Company Name, Address and Phone number:

Indicate what contracts did this company provided for you? Provide the total contract amount, dates of performance, and contract number.

Evaluation Questions

Please rate the overall quality of work using a scale of (Excellent, Good, Fair, Marginal, Unacceptable). Comments in support of the rating are welcome.

Were there any performance issues/concerns? If so, how were they handled?

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