ATTACHMENT 1 - PPQ.docx

ATTACHMENT 1 - PAST PERFORMANCE QUESTIONAIRE AND COVER LETTER

Complete one set of letters and forms for at least three projects identified in your firm’s SF 330 Section F, Example Projects Which Best Illustrate Proposed Team’s Qualifications For This Contract. Additional space or blank sheets may be added to answer any question.

Transmittal Letter to Accompany Past Performance Questionnaire

[Insert Company Name] is currently responding to Castle Point VA Medical Center request for SF 330, Architect-Engineer Qualifications for the “Water Tower Rehabilitation”. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance.

[Insert Company Name] is providing past performance data to Hudson Valley Health Care System relating to our performance on contract [Insert contract name/number] and have identified [Insert name of reference] as the point of contact for this contract.

The request for SF 330 instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire and submit it by 2:00 PM, EST on February 3, 2021 directly to the VISN 2/Network Contracting Office (NCO) Contract Specialist. The requested data may be submitted by mail or email to the government representative identified below. If the Past Performance Questionnaire is emailed, DO NOT send a hard copy via mail.

Aletha Bourke Contract Specialist Networking Contracting Office 2 FDR Montrose VA Medical Center 2094 Albany Post Road, Bldg. 29, Room 314 Montrose, NY 10548 Email: Aletha.Bourke@va.gov

The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to [Insert Company Name]. Please direct any questions about the acquisition or the attached questionnaire to the NCO2 point of contact identified above.

Thank you, [Insert Company Official Name and Title]

A. GENERAL INFORMATION

A-E FIRM TO BE EVALUATED:

Firm Name: ________________________ Telephone: __________________________ Address: __________________________ Email address: ________________________ __________________________ Point of Contact: ______________________

Firm Cage Code: ____________________ Firm Tax ID Number: ________________ Firm DUNS Number: ________________

Project Title: _____________________________________ Description of Project: __________________________________________________________

Description of A-E Firms’ Responsibilities:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contract Number: ______________________ Dollar Amount: ______________________ Contract Period of Performance: _______________________ The A-E Firm performed as the Prime Contractor Sub-Contractor/Consultant/Team Member Percent of work performed by A-E Firm: Other (Please describe) __________________

B. EVALUATOR INFORMATION:

Evaluator’s Company or Agency Name: ____________________________ Evaluator’s Name: _____________________ Address: __________________________ Title of Evaluator: _____________________ __________________________ Telephone: __________________________ __________________________ E-mail: ______________________________ C. SEND COMPLETED QUESTIONAIRE (SECTIONS B through D)TO:

Aletha Bourke Contract Specialist Networking Contracting Office 2 FDR Montrose VA Medical Center 2094 Albany Post Road, Bldg. 29, Room 314 Montrose, NY 10548 Email: Aletha.Bourke@va.gov

D. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Marginal or Unsatisfactory on page 7 under Narrative Summary.

-Performance meets or met contractual requirements and exceeds or exceeded many of your company’s expectations The contractual performance reflects or reflected few minor problems and corrective actions taken by the contractor appear to be highly effective or corrective actions taken were effective.

A-E FIRM’S NAME: _______________ PROJECT NAME: _______________

Contract Period of Performance: _______________________ Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix on page 4.

Item

FACTORS TO BE RATED

Design Services:

Follow-On Construction Support Services:

LEED (If Applicable):

BIM (If Applicable):

Owner’s Representative on Design/Build Projects (If applicable):

Overall:

YES

NO

Number of A/E Design Errors & Omissions on Project: _______________ Increased Project Cost Due to A/E Design Errors & Omissions:_______________

CONTRACTOR’S NAME: ___________________ PROJECT NAME ______________________

Contract Period of Performance: _______________________ Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

NARRATIVE SUMMARY (Use this section to explain any rating from the previous page)