ATTACHMENT 3 - PERFUSIONIST PAST PERFORMANCE SURVEY.docx
DOCX document 24 KB Posted
- Attached to
- Q523--Perfusionist Services New Requirement Base + 4 Federal contract opportunity
- Solicitation number
- 36C24924R0041
About this file
This document is a Past Performance Survey related to a federal contract opportunity for 24/7/365 on-call perfusionist services. The Department of Veterans Affairs (VA) is seeking offerors for a VA contract with a base year plus four option years. The survey evaluates the past performance of a contractor providing these services, including compliance with requirements, knowledge and expertise, personnel quality, access to personnel, scheduling, and patient privacy protections. Respondents are asked to rate the contractor's performance across these areas using a defined scale, and indicate whether they would award another contract to the firm. The related federal contract opportunity has the solicitation number 36C24924R0041 and is for a new requirement for Perfusionist Services with a base year plus four option years.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C24924R0041 0002.docx | DOCX document | |
| 36C24924R0041 0001.docx | DOCX document | |
| ATTACHMENT 1 - PERFUSIONIST QASP.docx | DOCX document | |
| ATTACHMENT 2 - CONTRACTOR CERTIFICATION OF IMMIGRATION.pdf | ||
| 36C24924R0041_1.docx | DOCX document |
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Text version
ATTACHMENT 3 – PERFUSIONIST PAST PERFORMANCE SURVEY
PAST PERFORMANCE SURVEY
24/7/365 ON-CALL PERFUSIONIST SERVICES
REFERENCE INSTRUCTIONS: The Department of Veterans Affairs is seeking offerors for award of a VA contract for 24/7/365 on-call perfusionist services for a base year plus four option years. You have been identified as a reference and your comments would be appreciated. Your comments are considered Source Selection Sensitive; therefore, you are advised that the release of the names of individuals providing reference information about Offeror’s past performance is prohibited. Survey should be completed by evaluator and submitted no later than August 12, 2024 @ 3:00 p.m. CT via email directly to robert.pritchard2@va.gov.
NOTE: Incomplete or unsigned surveys will not be considered.
Company being evaluated:_______________________________________________ Period of Performance:__ What was the average monthly volume of the services provided? (Number of cases per month? Average number of hours per case?) __ ____________________________________ Name and title/position of evaluator:
Contact telephone number:
Contact e-mail address:
Please evaluate the past performance using only the following ratings without variation. If the rating is other than Fully Acceptable, please provide additional information in the appropriate block or in the remarks section of this form.
S = Superior Performance
V = Very Good with very few issues
F = Fully Acceptable/Good
M = Marginally Acceptable
U = Unacceptable Performance
| Please rate and provide information/comments for the following: |
| Circle/indicate selection |
| Q1. Rate how well the contractor complies with requirements and/or expectations? |
| S V F M U |
| Q2. Rate contractor’s knowledge and expertise in providing on-call neurosurgery services. |
| S V F M U |
| Q3. Rate this contractor’s neurosurgeons. |
| S V F M U |
| Q4. Rate the level of access to the contractor’s personnel. (i.e. Did they respond in a timely manner? Did they meet the requirements of being available and responding as according to the contract?) |
| S V F M U |
| Q5. Rate overall ease of contractor’s scheduling process. |
| S V F M U |
| Q6. Rate how well contractor protects the privacy of patients. |
| S V F M U |
Q9. Would you award another contract to the firm being evaluated? If no, please explain:
Yes No
Additional Remarks: Please use this space to indicate anything else you would like to say about the contractor being referenced or to list anything you especially liked or disliked about this contractor:
| Signature of Evaluator |
| Date |
File details come from the government source that posted it. Updated .