ATTACHMENT 2 - PAST PERFORMANCE QUESTIONNAIRE.docx
DOCX document 17 KB Posted
- Solicitation number
- 36C10F21R0016
About this file
This document contains a past performance questionnaire and details of a federal contract opportunity. The past performance questionnaire requests information from contractors about prior projects, including contract details, completion dates, values, and performance ratings in areas such as quality, schedule, cost control and customer satisfaction. The federal contract opportunity is for phase 1B development at the Western New York National Cemetery, to provide approximately 9,942 additional gravesites over 30 acres. The solicitation number is 36C10F21R0016 and is issued by the Department of Veterans Affairs Office of Construction and Facilities Management. The development will provide an additional 10 years of continued burial services and comprises the second phase of cemetery development, including new burial sections.
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Attachment 2 – Past Performance Questionnaire
PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and return it via email to: E.J. Jean-Jacques (Evenel.Jean-Jacques@va.gov)
Desired Response Date: NLT 03/31/2021 4:30 p.m. ET
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY OFFEROR
1a. CONTRACTOR NAME & ADDRESS:
2. CONTRACT NO.:
3. CONTRACT AWARD DATE:
4. COMPLETION DATE:
5. CONTRACT VALUE (with options): $
1b. NAME OF PRIME CONTRACTOR (If this questionnaire is for a team member)
6. TYPE OF CONTRACT:
7. PROJECT TITLE, LOCATION, AND DESCRIPTION (AND TOTAL CONSTRUCTION VALUE AT PROJECT COMPLETION):
Please add a continuation page if additional space necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.
| E = Exceptional |
| S = Satisfactory |
| U = Unacceptable |
| G = Very Good |
| M = Marginal |
| N/O = Not Observed |
A. Quality of Products and Services - Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).
E G S M U N/O
B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.
E G S M U N/O
C. Schedule – Assess the timeliness of contractor against the schedule of activities.
E G S M U N/O
D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.
E G S M U N/O
E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.
E G S M U N/O
F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.
E G S M U N/O
G. Overall Assessment.
E G S M U N/O
Comments (for any ratings of E, G, M, or U, please provide some brief comments about strengths & weaknesses you observed in this contractor that help us understand your rating. Feel free to provide additional pages if necessary):
File details come from the government source that posted it. Updated .