ATTACHMENT 1 - PAST PERFORMANCE SURVEY.docx
DOCX document 14 KB Posted
- Attached to
- R428--Modification for Ergonomic Employee Evaluations - VASFHCS Federal contract opportunity
- Solicitation number
- 36C26124Q0434
About this file
This document is a Past Performance Survey that is used to evaluate a company's past performance for a potential VA contract. The survey requests information from the evaluator on the services the company provided, the total contract amount, dates of performance, and the contract number. The evaluator is asked to rate the overall quality of the company's work using a scale of Excellent, Good, Fair, Marginal, or Unacceptable, and to provide comments on any performance issues or concerns and how they were handled.
The related federal contract opportunity is Solicitation Number 36C26124Q0434 for R428--Ergonomic Employee Evaluations - VASFHCS, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21. The solicitation document is attached, but not provided in the information given.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C26124P1083_1.docx | DOCX document | |
| EXAMPLE 3 - VA Hospital - Office Ergonomic Report.pdf | ||
| QUESTIONS AND ANSWERS.pdf | ||
| EXAMPLE 2 - Ergonomic Evaluation.pdf | ||
| 36C26124Q0434 0001_1.docx | DOCX document | |
| EXAMPLE 1 - Office Ergonomic Report.pdf | ||
| REV.04-05-2024 RFQ 36C26124Q0434 - Ergonomic Evaluations.pdf | ||
| 36C26124Q0434_1.docx | DOCX document | |
| ATTACHMENT 5 - WD2015-5673_REV.19_Humboldt-Lake-Mendocino-DelNorte_12-26-2023.pdf | ||
| ATTACHMENT 4 - WD2015-5651_REV.19_Sonoma_12-25-2023.pdf | ||
| ATTACHMENT 3 - WD2015-5637_Rev.25_SAN FRANCISCO_12_26_2023.pdf | ||
| ATTACHMENT 2 - WD2015-5627_Rev.19_Shasta_12-26-2023.pdf |
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Text version
Past Performance Survey
OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be submitted directly to durell.salaz@va.gov.
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.
Please Note: When completing this Survey be sure to summarize what service(s) you provided on the contract(s) to include the performance dates, dollar amount(s) and contract number(s).
Name of Company being evaluated:
Evaluator’s Name and signature:
Evaluator’s Company Name, Address and Phone number:
Indicate what services 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?
File details come from the government source that posted it. Updated .