Attachment 3 PAST PERFORMANCE QUESTIONNAIRE 02.docx

Past Performance Questionnaire (PPQ)

PACKAGE INFORMATION AND FORMS

Instructions to Offeror for sending Reference Questionnaire Forms: Prepare and send a Past Performance Questionnaire package to the references you identified for each commercial, Federal or non-Federal Government project you listed in your response to Technical Factor 1: Past Performance. It is your responsibility to follow-up and to encourage your references to send in their questionnaire. If you have multiple references at one location, email one cover letter and questionnaire for each project/contract you want a reference for. Your questionnaire package should contain the following.

Cover Letter (See attached Sample) Performance Questionnaire (See attached Sample).

Offeror should put their name in spaces indicated and ensure it is on every page for identification purposes

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE!

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

SAMPLE COVER LETTER AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Your Company Letterhead

Date:

To:

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the Department of Veterans Affairs, Office of Construction & Facilities Management. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the Offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to the following address to arrive NOT LATER THAN MAY 28, 2021. Do not return them to our company. NOTE: RETURN VIA EMAIL ONLY Comment by Steele, Alicia M. (CFM): Discrepancy with the date listed below.

Email response to: Elizabeth.Monohan@va.gov

If you have questions regarding the attached questionnaire, or require assistance, please contact Elizabeth Monohan, Contracting Officer at (202) 632-5861.

Thank you for your assistance.

Offeror Signature and Title

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and mail or send via email to: Elizabeth Monohan (Elizabeth.Monohan@va.gov)

Office of Construction and Facilities Management 425 I Street, NW Washington, DC 20001 Desired Response Date: NLT noon 05/28/2021

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.

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):