Attachment 12 - PPQ NCO 20 463-21-101.docx
DOCX document 112 KB Posted
- Attached to
- Repair Bld Moisture Barrier Proj 463-21-101
- Solicitation number
- 36C26026R0061_RFP
About this file
This is a Past Performance Questionnaire (PPQ) template for evaluating contractor performance on federal construction projects administered by the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Regional Procurement Office-West (RPOW), Network Contracting Office 20 (NCO 20). The PPQ is specific to solicitation number 36C26026R0061 for the Repair Building 100 Moisture Barrier Project (#463-21-101) located at Anchorage VA Medical Center, 1201 N Muldoon Road, Anchorage, Alaska 99504. This is a construction contract type.
The template requires offerors to provide contractor information, project details, and reference contact information, while the evaluator (client/past performance reference) must complete a comprehensive assessment across seven performance categories: Quality, Schedule/Timeliness of Performance, Communication, Management/Personnel/Labor, Cost/Financial Management, and Subcontract Management. Evaluators rate performance using adjectival ratings (Outstanding, Above Average, Satisfactory, Unsatisfactory, or Not Applicable) with accompanying detailed definitions. The project scope involves correcting moisture barrier deficiencies in Building 100's envelope at multiple exterior and interior locations, repairing moisture-related surface damage, and ensuring compliance with infection control and safety standards while maintaining operations at an active healthcare facility. Award date, original contract acceptance date, and final contract pricing were listed as "TBD" in this template document. PPQs should be returned by the offeror for inclusion in proposal submissions and must not be submitted directly to NCO 20 by the reference client.
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Text version
VHA NETWORK CONTRACTING OFFICE 20 ● 1601 E. FOURTH PLAIN BLVD BLDG. 17, SUITE B428 ● VANCOUVER, WA
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
SECTION 1
CONTRACT INFORMATION – Contractor to complete #1-3
1. CONTRACTOR INFORMATION
NAME OF OFFEROR BEING EVALUATED: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
POINT OF CONTACT: Click or tap here to enter text.
CONTACT PHONE NUMBER: Click or tap here to enter text.
CONTACT EMAIL ADDRESS: Click or tap here to enter text.
WORK PERFOMED AS: Click or tap here to enter text.
PERCENT OF PROJECT WORK PERFORMED: Click or tap here to enter text.
IF SUBCONTRACTOR, WHO WAS THE PRIME? Click or tap here to enter text.
2. CONTRACT INFORMATION
CONTRACT TITLE: Repair Building 100 Envelope Moisture Barrier
CONTRACT NUMBER AND DO/TO NUMBER: 36C26026R0061
CONTRACT TYPE: Construction if other:
CONTRACT LOCATION: Anchorage VA Medical Center, 1201 N Muldoon Rd, Anchorage, AK 99504
AWARD DATE: TBD
ORIGINAL CONTRACT ACCCEPTANCE (construction accepted) Date: TBD
ACTUAL CONTRACT ACCEPTANCE: TBD
EXPLAIN DIFFERENCES: TBA
ORIGINAL CONTRACT PRICE (all costs - design/installation/financing): TBD
FINAL CONTRACT PRICE (including modifications, if applicable): TBD
EXPLAIN DIFFERENCES: Adjustments due to approved change orders for unforeseen conditions and VA-directed scope changes.
3. PROJECT DESCRIPTION
SCOPE INCLUDED IN PROJECT: Correct moisture barrier deficiencies in Building 100 envelope at multiple exterior/interior locations; repair moisture-related surface damage; ensure compliance with infection control and safety standards; sequence work to avoid disruption to medical center operations.
HOW IS THIS PROJECT RELEVANT TO PROJECT OF SUBMISSION? Similar complexity and scope involving building envelope repairs, moisture mitigation, and work in an active healthcare environment under strict safety and infection control protocols.
SECTION 2
EVALUATOR INFORMATION – Client to complete
Veterans Health Administration (VHA) Regional Procurement Office-West (RPOW) Network Contracting Office 20 (NCO 20) is considering the Offeror identified above for award of the CON-NRM-463-21-101 Repair Bldg 100, Anchorage, AK.
Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate the company’s ability to perform the work as described in the solicitation. Please verify the accuracy of the information in Section 1 and complete the questionnaire as thoroughly as possible. NCO 20 may contact you in order to obtain any additional information regarding a contract award.
Please return your completed questionnaire to the Offeror to be incorporated into the proposal submission. PPQs should NOT be submitted directly to NCO 20 by the client. Refer to the solicitation for proposal submission due date.
EVALUATOR INFORMATION
NAME OF EVALUATOR: Click or tap here to enter text.
POSITION: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
PHONE: Click or tap here to enter text.
EMAIL: Click or tap here to enter text.
DESCRIBE YOUR ROLE IN THE PROJECT: Click or tap here to enter text.
*Please see Page 4 for Adjectival Ratings for the following:
1. QUALITY
| Ability to meet quality design and/or construction standards specified for technical performance |
| Choose an item. |
| Comments: |
2. SCHEDULE/ TIMELINESS OF PERFORMANCE
| Compliance with contract delivery/completion schedules including timely submission of data deliverables (If liquidated damages were assessed or the schedule was not met, please address below.) |
| Choose an item. |
| Comments: |
3. COMMUNICATION
| Contractor was reasonable and cooperative in dealing with client staff (including the ability to successfully resolve disagreements/disputes and responsiveness to client requests) |
| Choose an item. |
| Comments: |
4. MANAGEMENT/ PERSONNEL/ LABOR
| Effectiveness of management, including suppliers, materials, and/or labor force (including the ability to effectively lead, manage, and control the project) |
| Choose an item. |
| Continuity in the contractor’s personnel during execution of the contract (e.g., one person or team that stayed with the project throughout the contract) |
| Choose an item. |
| Comments: |
5. COST/ FINANCIAL MANGEMENT
| Ability to meet the terms and conditions within the contractually agreed price |
| Choose an item. |
| Comments: |
6. SUBCONTRACT MANAGEMENT
Ability to manage subcontracting effort, including any subcontracting issues, and the contractor’s ability to resolve the problems without extensive customer guidance
Choose an item.
Comments:
7. SUMMARY
| Would you hire or work with this firm again? If no, please explain below. |
| Choose an item. |
| Provide an overall rating for the work performed by this contractor. |
| Choose an item. |
ADDITIONAL COMMENTS:
| EVALUATOR SIGNATURE: |
| DATE: |
ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
*THIS PAGE WILL BE REMOVED FOR EVALUATION PURPOSES AND NOT BE COUNTED TOWARD THE PROPOSAL PAGE COUNT – IT IS FOR PPQ COMPLETION PURPOSES ONLY*
| Rating |
| Definition |
| Outstanding |
| The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective. |
| Above Average |
| The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Offeror were effective. |
| Satisfactory |
| The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Offeror were satisfactory. |
| Unsatisfactory |
| Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the Offeror has yet to identify corrective actions or the Offeror’s proposed actions appear only marginally effective or were not fully implemented. |
| Not Applicable |
| No information or did not apply to your contract. |
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