Attachment_3_Past_Performance_Questionnaire.pdf
PDF 184 KB Posted
- Solicitation number
- 36C77023R0003
About this file
This document contains a past performance questionnaire for a contractor to complete regarding previous work performed under Contract Number MbM Office Expansion. The questionnaire requests information on the contractor's role, contract details including value and completion dates, and ratings for performance criteria such as quality of work, responsiveness, communication, and quality control. The contractor is asked to provide references and evaluate its own performance on a scale of Outstanding, Above Average, Satisfactory, Marginal, or Unacceptable for each criteria. Additionally, the federal contract opportunity provides details for Solicitation Number 36C77023R0003 regarding an expansion project at the Meds by Mail facility in Murfreesboro, Tennessee to be awarded by the Department of Veterans Affairs Veterans Health Administration VISN 15.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77023R0003 0003.docx | DOCX document | |
| Pre-Bid_Questions with Photos.pdf | ||
| Pre-Bid_Sign-In.pdf | ||
| 36C77023R0003 0002.docx | DOCX document | |
| 36C77023R0003 0001.docx | DOCX document | |
| Floor_Plan.pdf | ||
| 36C77023R0003_1.docx | DOCX document | |
| Specifications.pdf |
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Text version
Solicitation No. 36C77023R0003
ATTACHMENT 5 - PAST PERFORMANCE QUESTIONNAIRE
1. Contractor Information
Firm Name:
Address:
Phone Number:
Point of Contact:
Contact Phone Number:
UEI Number:
2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other
Percent of project work performed:
If subcontractor, who was the prime (Name/Phone #):
3. Contract Information Contract Number:
Delivery/Task Order Number (if applicable):
Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):
Contract Title:
Contract Location:
Project Description:
Complexity of Work High Med Routine Award Date (mm/dd/yyyy):
Contract Completion Date (mm/dd/yyyy):
Actual Completion Date (mm/dd/yyyy):
Explain Differences:
Original Contract Price (Award Amount):
Final Contract Price (to include all modifications, if applicable):
Explain Differences:
Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT RATE ON A “+” OR “- “SCALE. If a “+” or “- “is used, the rating without the "+" or "-" will be applied. In addition to the ratings, please provide a short narrative in the appropriate block or in the remarks section of this form.
“O” 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.
Please rate and provide any supporting information/comments for the following:
1. The quality of the working relationship with the client (the tenant and/ or owner).
O A S M U
2. The professionalism and integrity with which offeror conducted business.
O A S M U
3. The responsiveness to the client’s needs and expectations.
4. The Offeror’s ability to successfully management and perform the project.
5. The offeror’s level of communication.
6. The quality control of the project.
7. Any Value added to the project as the result of cost savings, favorable financing, positive asset management, etc.
Yes No
“A” 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.
“S” 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.
“M” Marginal Performance did not meet some contractual requirements. Performance indicated that there are some potential risks associated with the quality products, timeliness of service, and contract performance.
“U” Unacceptable 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.
8. Would you award another contact to the party being evaluated? If no, please explain.
Yes No
9. The delivery of the project within the budget and on schedule.
10. Other relevant aspects in the management of a project development for the client.
11. Overall rating for this firm: O A S M U
Signature of Evaluator
Date
MbM Office Expansion
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