Attachment 2_Past Performance Questionnaire_8 December 2020.docx
DOCX document 17 KB Posted
- Attached to
- Anesthesiology Services-Non-Personal Services Federal contract opportunity
- Solicitation number
- W81K00-21-R-3001
- Issued by
- Department of the Army Medical Command
About this file
This document contains a past performance questionnaire and details of a solicitation for anesthesiology services. The past performance questionnaire is seeking input on an incumbent contractor providing anesthesiology services at William Beaumont Army Medical Center in El Paso, Texas under a previous contract or order. It requests contract details and performance ratings in quality of service and business relations. The related solicitation seeks non-personal anesthesiology services including twelve certified registered nurse anesthetists and two physician anesthesiologists. The base period of performance is April 1, 2021 through September 30, 2021 with five option periods through March 31, 2026. The requirement will be competitively solicited as an 8(a) small business set-aside. The NAICS code is 621111 for offices of physicians and the size standard is $12 million in average annual revenue. Responses are due by January 7, 2021 and the solicitation will only be available electronically.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Revised PWS_5 Jan 2021.pdf | ||
| Revised_Attachment 4_Pricing Worksheet_5 Jan 2021.xlsx | XLSX spreadsheet | |
| W81K00-21-R-3001 Amendment 1_5 Jan 2021.pdf | ||
| Questions_Answers_Anesthesiology Services_5 Jan 2021.pdf | ||
| 15-5230_SCA.pdf | ||
| Instructions to Offerors_Evaluation Criteria_9 December 2020_UPDATE.pdf | ||
| W81K00-21-R-3001_8 December 2020.pdf | ||
| Attachment 3_Sample Compensation Plan_8 December 2020.xlsx | XLSX spreadsheet | |
| Attachment 4_Pricing Worksheet_8 December 2020.xlsx | XLSX spreadsheet | |
| Performance Work Statement_8 December 2020.pdf | ||
| Instructions to Offerors_Evaluation Criteria_8 December 2020.pdf | ||
| Attachment 1_Past Performance Information (PPI) Sheet_8 December 2020.docx | DOCX document |
Show all 12
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT 2
W81K00-21-R-3001 8 December 2020
PAST PERFORMANCE QUESTIONNAIRE
The Regional Health Contracting Office – Central (RHCO-C) is conducting a competitive acquisition for services to establish, Anesthesiology Services at William Beaumont Army Medical Center (WBAMC), El Paso, 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 7 January 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. How long has your company had a contract with this contractor?
2. Type of service being provided?
3. Where is the location of this service?
4. What is the contract amount?
5. How many Full Time Equivalents (FTE) are on the contract?
6. Have there been late deliveries or other 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 contract statement of work requirement.
(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 .