Attach 3_Past Performance Questionnaire_29 July 2021_21-R-3014_Optical.docx
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- Attached to
- Optical Non-Personal Services Federal contract opportunity
- Solicitation number
- W81K0021R3014
- Issued by
- Department of the Army Medical Command
About this file
This document includes a past performance questionnaire and details of a solicitation for optical non-personal services. The past performance questionnaire is for a contractor identified as a reference by an offeror bidding on Solicitation W81K00-21-R-3014 issued by the Regional Health Contracting Office - Central. It requests information on the type of services provided, contract amount, location, number of FTEs, unsatisfactory performance, quality of service rating and narrative if not satisfactory, and business relations rating and narrative if not satisfactory. The solicitation is for optical non-personal services for the Optical Fabrication Laboratory at Brooke Army Medical Center. Offerors must submit proposals electronically by 2:00PM Central Time on August 17, 2021 to the points of contact listed. Questions are due by 2:00PM Central Time on August 3, 2021. The solicitation is issued by the Department of the Army Medical Command.
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Text version
Attachment 3
| W81K00-21-R-3014 |
| 29 July 2021 |
PAST PERFORMANCE QUESTIONNAIRE
The Regional Health Contracting Office – Central (RHCO-C) is conducting a competitive acquisition for Non-Personal Optical Services for the Optical Fabrication Laboratory, Brooke Army Medical Center (BAMC), JBSA, Fort Sam Houston, Texas. The offeror has identified you as a reference to validate past performance.
Please complete the following questionnaire to assist our evaluation of the contractor’s past performance, and return to rosalba.martinez1.civ@mail.mil and robin.m.castro.civ@mail.mil by 17 August 2021, 2:00PM CT (San Antonio, Texas). Note: Clearly identify and provide the name of the Prime Contractor and Subcontractor. Specify Prime Contractor/Subcontractor.
Name of Contractor being evaluated:
Contract/Order Number: __________________________________________________________________
1. Type of service being provided?
2. Where is the location of this service?
3. What is the contract amount?
4. How many Full Time Equivalents (FTE) are on the contract?
5. Have there been any unsatisfactory performance resulting in additional contractual or administrative costs?
Yes |_| No |_| If “Yes,” explain:
The last two questions will discuss quality of service & customer relations. Please refer to the following:
Rating System:
1. Excellent – Overall performance exceeds contractual requirements and gives extra benefits to the customer. Problems, if any, were promptly corrected without negative impact to the customer.
1. Satisfactory – Performance meets contractual requirements. The contractual performance contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory
1. Marginal - Performance does not meet some contractual requirements. The contractor’s proposed actions to correct any problems appear only marginally effective or were not fully implemented.
1. Unsatisfactory – Performance does not meet most contractual requirements. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
IMPORTANT NOTE: NARRATIVES MUST BE PROVIDED FOR ANY RATING OTHER THAN SATISFACTORY AND MUST SUPPORT THE RATING GIVEN.
PAST PERFORMANCE QUESTIONNAIRE, Continued
7. Quality of Service – Please rate overall compliance with the contract Performance Work Statement.
(1) Excellent |_| (2) Satisfactory |_| (3) Marginal |_| (4) Unsatisfactory |_|
If other than “Satisfactory,” a narrative must be provided to explain how the overall performance exceeds or does not meet contractual requirements:
8. Business/Customer Relations – Please rate overall effective management; successfully managed services; reasonable/cooperative behavior; flexibility; business-like concern for customer’s interest.
(1) Excellent |_| (2) Satisfactory |_| (3) Marginal |_| (4) Unsatisfactory |_|
If other than “Satisfactory,” a narrative must be provided to explain how the overall performance exceeds or does not meet contractual requirements:
Signature: Date:
Print Name: Company:
Title: Telephone:
Thank you for your participation in providing a detailed and accurate history of past performance for this offeror.
File details come from the government source that posted it. Updated .